| Richard Wagner, MD | |
|
2900 S Loop 256, Palestine, TX 75801-6958 | |
| (903) 731-1144 | |
| Not Available |
| Full Name | Richard Wagner |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine - Emergency Medical Services |
| Location | 2900 S Loop 256, Palestine, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881647956 | NPI | - | NPPES |
| 096949512 | Medicaid | TX | |
| 096949513 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 35C.001377 (Ohio) | Secondary |
| 207PE0004X | Emergency Medicine - Emergency Medical Services | J4594 (Texas) | Primary |
| Entity Name | Concord Medical Group Of Texas Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750790762 PECOS PAC ID: 7810117223 Enrollment ID: O20141007002567 |
| Entity Name | Ess Of South Texas Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295128247 PECOS PAC ID: 9739491176 Enrollment ID: O20150629000248 |
| Entity Name | Ess Of Fairfield Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588132856 PECOS PAC ID: 9234475526 Enrollment ID: O20190108000545 |
| Entity Name | Ess Of Lubbock Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174255251 PECOS PAC ID: 8729460134 Enrollment ID: O20220802001691 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Wagner, MD 904 Drane Pl, Corsicana, TX 75110-2536 Ph: () - | Richard Wagner, MD 2900 S Loop 256, Palestine, TX 75801-6958 Ph: (903) 731-1144 |
Heidi Christine Knowles, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2900 S Loop 256, Palestine, TX 75801 Phone: 903-731-1144 | |
George Eric Schroeder, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2900 S Loop 256, Palestine, TX 75801 Phone: 903-731-1144 | |
Chad Crystal, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2900 S Loop 256, Palestine, TX 75801 Phone: 903-731-1144 | |
Dr. Sunao Lynette Gilbert, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2900 S Loop 256, Palestine, TX 75801 Phone: 903-773-1153 | |
Nejla Shami, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2900 S Loop 256, Palestine, TX 75801 Phone: 903-731-1144 | |
Benjamin Constante, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2900 S Loop 256, Palestine, TX 75801 Phone: 903-731-1144 |