| Kennon D Wigley, MD | |
|
2700 E 29th Street, Suite 220, Bryan, TX 77802 | |
| (979) 774-4008 | |
| (979) 774-7893 |
| Full Name | Kennon D Wigley |
|---|---|
| Gender | Male |
| Speciality | Cardiovascular Disease (cardiology) |
| Experience | 42 Years |
| Location | 2700 E 29th Street, Bryan, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215904495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RC0000X | Internal Medicine - Cardiovascular Disease | G5771 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Joseph Regional Health Center | Bryan, TX | Hospital |
| Madison St Joseph Health Center | Madisonville, TX | Hospital |
| Bellville St Joseph Health Center | Bellville, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Central Texas Heart Center | 6901880863 | 10 |
| Cardiac Cath Lab Of Bryan College Station Lp | 8628296738 | 9 |
| Entity Name | Central Texas Heart Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871666271 PECOS PAC ID: 6901880863 Enrollment ID: O20040617001706 |
| Entity Name | Cardiac Cath Lab Of Bryan College Station Lp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114346723 PECOS PAC ID: 8628296738 Enrollment ID: O20140903001691 |
| Mailing Address | Practice Location Address |
|---|---|
| Kennon D Wigley, MD 2700 E 29th Street, Suite 220, Bryan, TX 77802 Ph: (979) 774-4008 | Kennon D Wigley, MD 2700 E 29th Street, Suite 220, Bryan, TX 77802 Ph: (979) 774-4008 |
Christopher Joseph Derbes, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2206 E Villa Maria Rd, Bryan, TX 77802 Phone: 979-776-4600 Fax: 979-774-0877 | |
Mrs. Nalini M Dave, M.D. Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 1201d Briarcrest Dr, Bryan, TX 77802 Phone: 979-776-5600 Fax: 979-776-6280 | |
Brent Morgan Gray, M.D. Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 2206 E Villa Maria Rd, Bryan, TX 77802 Phone: 979-776-4600 Fax: 979-774-0877 | |
Dr. Terry R Jenkins, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2215 E Villa Maria Rd, #110, Bryan, TX 77802 Phone: 979-776-2000 Fax: 979-776-0427 | |
Dr. Rejeesh Vijaya Vasudev, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2110 E Villa Maria Rd, Bryan, TX 77802 Phone: 979-822-5555 | |
Dr. Thomas Mark Weber, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2700 E 29th St Ste 260, Bryan, TX 77802 Phone: 979-774-0012 Fax: 979-774-4636 | |
Dr. Scott Edward Spencer, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2700 E 29th St, 260, Bryan, TX 77802 Phone: 979-774-0012 Fax: 979-774-4636 |