DAX ELI WAGNER


Address: 815 Hanks St, Lufkin, TX 75904-4961
Phone: 9366352840

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 815 HANKS ST
City LUFKIN
State TX
Zip Code 75904-4961

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NPI Name Taxonomy Address Enumeration
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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
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1124523840 Jane C Davidson Nurse Practitioner 1 Medical Center Blvd Ste C, Lufkin, TX 75904 2018-03-26
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Taxonomy Information

Taxonomy Code 247100000X
Grouping Technologists, Technicians & Other Technical Service Providers
Classification Radiologic Technologist

Taxonomy Definition

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.

Providers in the same taxonomy and state

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
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Competitor

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City LUFKIN
Zip Code 75904

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Dataset Information

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.

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