| Drs Wagner & Wagner Pa | |
|
124 E Wolters 2nd Shiner TX 77984-7109 | |
| (361) 594-3824 | |
| (361) 594-4104 |
| Full Name | Drs Wagner & Wagner Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 124 E Wolters 2nd, Shiner, Texas |
| Authorized Official Name and Position | Ralph Wagner (PARTNER) |
| Authorized Official Contact | 3615943824 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Drs Wagner & Wagner Pa Po Box 965 Shiner TX 77984-0965 Ph: (361) 594-3824 | Drs Wagner & Wagner Pa 124 E Wolters 2nd Shiner TX 77984-7109 Ph: (361) 594-3824 |
| NPI Number | 1124087887 |
|---|---|
| Provider Enumeration Date | 03/21/2006 |
| Last Update Date | 07/18/2008 |
| Medicare PECOS PAC ID | 6507853280 |
|---|---|
| Medicare Enrollment ID | O20040426001529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124087887 | NPI | - | NPPES |
| 00J16X | Other | TX | BLUE CROSS |
| 083112501 | Medicaid | TX | |
| 017726301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H4771 (Texas) | Primary |
| Provider Name | Ralph A Wagner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447231881 PECOS PAC ID: 3173510526 Enrollment ID: I20100105000016 |
| Provider Name | Marshall C Bishop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821079260 PECOS PAC ID: 1355338807 Enrollment ID: I20100324000282 |
| Provider Name | Timothy J Wagner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851372619 PECOS PAC ID: 8628065075 Enrollment ID: I20100614000054 |
Shiner Medical Llp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 124 E Wolters, Shiner, TX 77984 Phone: 361-594-3824 Fax: 361-594-3854 | |
Sievers Medical Clinic - Shiner Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 207 West 7th Street, Shiner, TX 77984 Phone: 361-239-5015 Fax: 830-672-8481 | |
Wagner Medical Clinic L.l.p. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 124 E Wolters 2nd, Shiner, TX 77984 Phone: 361-594-3824 |