WAGNER MEDICAL CLINIC L.L.P. NPI 1356322127

NPI Information

WAGNER MEDICAL CLINIC L.L.P. is a rural health clinic center in Moulton, TX. WAGNER MEDICAL CLINIC L.L.P. NPI is 1356322127. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Moulton Clinic.

The provider's business location address is:

100 S PECAN
MOULTON, TX
ZIP 77975-238
Phone: (361) 594-3824

The provider's authorized official is Ralph Wagner .
The authorized official title is Md and has the following contact phone number (361) 594-3824.

The CLIA number assigned to this NPI record is 45D0902600 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/9/2005 and was last updated on 11/2/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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