DAX ELI WAGNER (NPI# 1205308707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205308707 |
Entity Type | Individual |
Full Name | DAX ELI WAGNER |
Practice Address |
815 Hanks St Lufkin TX 75904-4961 |
Practice Telephone | 9366352840 |
Mailing Telephone | 9366352840 |
Enumeration Date | 2018-12-20 |
Last Update Date | 2018-12-20 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 247100000X | Radiologic Technologist | GMR00096682 | TX | Technologists, Technicians & Other Technical Service Providers |
N | 2471C3401X |
Radiologic Technologist Specialization: Computed Tomography |
GMR00096682 | TX | Technologists, Technicians & Other Technical Service Providers |
N | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
GMR00096682 | TX | Technologists, Technicians & Other Technical Service Providers |
Street Address |
815 HANKS ST |
City | LUFKIN |
State | TX |
Zip Code | 75904-4961 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437759750 | David Kent Emmerling | Pharmacist | Walmart Pharmacy 10-0140, 2500 Daniel Mccall Drive, Lufkin, TX 75904 | 2020-10-27 |
1831732718 | Isaac Kwame Agyare | Pharmacist | 1522 West Frank Ave. Room 127, Lufkin, TX 75904 | 2019-10-23 |
1598314999 | Eva Faye Mcduffie | Technician | 1006 Sherwood Rd., Lufkin, TX 75904 | 2019-09-09 |
1477036119 | Tyra Williams | Occupational Therapy Assistant | 902 Hill Street, Lufkin, TX 75904 | 2018-09-10 |
1720560188 | Veronica Monique Kennedy | Pharmacist | 1522 West Frank, Lufkin, TX 75904 | 2018-09-02 |
1356821532 | Mark Anthony Plowman | Licensed Vocational Nurse | 379 Copperfield Loop, Lufkin, TX 75904 | 2018-08-17 |
1396222311 | Kevin Pulikottil Cherian | Occupational Therapist | 402 S John Redditt Dr., Lufkin, TX 75904 | 2018-07-23 |
1922593029 | Sarah Marie Stuart | Dentist | 103 N Brentwood Dr, Unit 400, Lufkin, TX 75904 | 2018-06-30 |
1083104004 | Pam Specialty Hospital of Lufkin, LLC | Long Term Care Hospital | 1201 W Frank Ave Ste D5, Lufkin, TX 75904 | 2018-05-15 |
1124523840 | Jane C Davidson | Nurse Practitioner | 1 Medical Center Blvd Ste C, Lufkin, TX 75904 | 2018-03-26 |
Find all providers in zip 75904 |
Taxonomy Code | 247100000X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Radiologic Technologist |
An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467087049 | Alaa Mohamed | Radiologic Technologist | 8330 Lyndon B Johnson Fwy Ste B302, Dallas, TX 75243-1166 | 2020-03-04 |
1346882628 | 247 Mobile X-ray Services LLC | Radiologic Technologist | 10407 Shanley Landing Ct, Richmond, TX 77407-2727 | 2019-10-08 |
1578041828 | Sarah Nichole Northcutt | Radiologic Technologist | 12517 Nicholas Pl, Rhome, TX 76078-6064 | 2018-07-30 |
1649779448 | Rafael Rodriguez | Radiologic Technologist | 11365 Montwood Dr Ste A, El Paso, TX 79936-3867 | 2018-02-07 |
1568997559 | Gregory Abdullah | Radiologic Technologist | 134 E Mistletoe Ave, San Antonio, TX 78212-3407 | 2017-04-27 |
1093261604 | Julio Alcala | Radiologic Technologist | 10291 Pellicano Suite 102, El Paso, TX 79935 | 2016-09-01 |
1700339959 | Nina Tokpawhiea | Radiologic Technologist | 9900 Adleta Blvd Apt 711, Dallas, TX 75243-9211 | 2016-07-24 |
1780058032 | Daniel Benard Suniga | Radiologic Technologist | 2250 Holly Hall St Apt 345, Houston, TX 77054-3941 | 2015-11-24 |
1104292119 | William Lewis Snyder Jr. | Radiologic Technologist | 551 Renee Ln, Desoto, TX 75115-5161 | 2015-08-12 |
1154717718 | Malina Marsh | Radiologic Technologist | 2110 Mariposa Lane, Arlington, TX 76101 | 2015-04-10 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.