Wagman, Randall

Wagman, Randall is an individual health care provider with primary practice located at 920 Highway 287 N Ste 300, Mansfield TX 76063-2627. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wagman, Randall can be contacted via phone (817) 539-0770.

Contact Information

Primary practice address
920 Highway 287 N Ste 300 Mansfield TX 76063-2627
Phone: (817) 539-0770
Fax: (817) 539-0772
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 11202R Louisiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M8410 Texas

Profile Details

NPI number 1225033574
LBN Legal business name Wagman, Randall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Feb 14th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225033574 NPPES
Texas MEDICAID 197913001
Texas MEDICAID 1667081

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