DR. JOHN WESLEY WAGGONER (NPI# 1710040886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710040886 |
| Entity Type | Individual |
| Full Name | DR. JOHN WESLEY WAGGONER |
| Credential | PSY.D. |
| Practice Address |
2200 Bergquist Dr 59 Mhs/sgowmp - Neuropsychology, 4th Floor Lackland A F B TX 78236-9907 |
| Mailing Address |
7507 Clos Du Bois San Antonio TX 78253-4888 |
| Practice Telephone | 2102925968 |
| Mailing Telephone | 2108722543 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2013-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | 1561 | AL | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1561 | AL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730354986 | John Craig Waggoner | Pharmacist | 510 Coronado St, Bonner Springs, KS 66012-1203 | 2008-04-29 |
| 1699336867 | John Ross Waggoner | Behavior Technician | 8000 West End Road, Anchorage, AK 99501 | 2019-06-27 |
| 1104320076 | John P Waggoner | Orthopaedic Surgery | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2018-03-23 |
| 1255779922 | John Hastings Waggoner | Physical Therapist | 2005 Avalon Ave, Muscle Shoals, AL 35661-3188 | 2013-06-04 |
| 1013352194 | John Robert Waggoner Jr. | Counselor | 4455 E 12th Ave, Denver, CO 80220-2415 | 2013-05-03 |
| 1922053016 | John W. Waggoner IIi | Internal Medicine | 500 Lilly Rd Ne, Suite 100, Olympia, WA 98506-5195 | 2006-05-24 |
| Street Address |
2200 BERGQUIST DR 59 MHS/SGOWMP - NEUROPSYCHOLOGY, 4TH FLOOR |
| City | LACKLAND A F B |
| State | TX |
| Zip Code | 78236-9907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235139494 | Kathryn Joyce | Nurse Practitioner | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2005-07-28 |
| 1619219789 | Jodie K Timberlake | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr, Willford Hall Ambulatory Surgical Center, Lackland A F B, TX 78236-9907 | 2013-03-26 |
| 1467798884 | James W Parry | Military Health Care Provider | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2012-12-13 |
| 1093065252 | Brittany Mccright | Physical Therapist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2012-09-14 |
| 1003177593 | Danielle Kusserow Bersabe | Internal Medicine | 2200 Bergquist Dr, Wilford Hall Ambulatory Surgical Center, Lackland A F B, TX 78236-9907 | 2012-05-31 |
| 1114206570 | Ana Ugues Aleman | Pharmacist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2011-08-16 |
| 1902192743 | Ashley Noelle Franz | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr, Wilford Hall Medical Center, Lackland A F B, TX 78236-9907 | 2011-06-20 |
| 1699067694 | Kristen Kann | Emergency Medicine | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2011-05-09 |
| 1891090577 | Evan Gregory Smith | Physician Assistant | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2011-01-11 |
| 1295041853 | Santos Michael Rivera II | Pharmacist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2010-08-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154309367 | Julie Michelle Storey | Psychologist | 2200 Bergquist Dr, Suite 1, Attn Credentials (cmc), Lackland A F B, TX 78236-9907 | 2006-01-06 |
| 1912985375 | Robert Karl Klepac | Psychologist | 2200 Bergquist Dr, Attn: Credentials (cmc), Lackland A F B, TX 78236-9907 | 2006-01-05 |
| 1053308528 | Monty Timothy Baker | Psychologist | 2200 Bergquist Dr, Ste. 1, Life Skills Support Center, 59 Mdos Mmcm, Lackland A F B, TX 78236-9907 | 2005-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517267 | Hunter Boone Small | Psychologist | 5940 Forest Park Rd Apt 1100, Dallas, TX 75235-6444 | 2020-10-27 |
| 1588263339 | Uttam Psychological Services Pllc | Psychologist | 16711 Cedar Yard Ln, Cypress, TX 77433-5250 | 2020-10-22 |
| 1194323097 | Ashleigh Elizabeth Fellows | Psychologist | 11750 Mission Trace St, San Antonio, TX 78230-2120 | 2020-10-13 |
| 1639776412 | Nausheen Noor | Psychologist | 3707 Springhill Ln, Sugar Land, TX 77479-2293 | 2020-10-05 |
| 1144834268 | Jeffrey Baldridge | Psychologist | 8140 Walnut Hill Ln Ste 450, Dallas, TX 75231-4328 | 2020-09-04 |
| 1871104760 | Nicole Elizabeth Hooper | Psychologist | 1 Stonebriar Ct, Dallas, TX 75206-8812 | 2020-08-13 |
| 1770194862 | Nichole Barbara Vincent | Psychologist | 829 Sunnyvale Pl, Uvalde, TX 78801-4078 | 2020-08-12 |
| 1992313522 | Aisha Iqbal | Psychologist | 5454 La Sierra Dr Ste 201, Dallas, TX 75231-2344 | 2020-07-20 |
| 1184241598 | Mellissa Tong | Psychologist | 113 W 33rd St, Austin, TX 78705-2313 | 2020-07-01 |
| 1821615733 | The Clinic Neuropsychological & Psychological Services, Pllc | Psychologist | 101 Uhland Rd Ste 205, San Marcos, TX 78666-6681 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
| City | LACKLAND A F B |
| Zip Code | 78236 |
Please comment or provide details below to improve the information on DR. JOHN WESLEY WAGGONER.
| 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.