DR. ALLEN C. WEGENER (NPI# 1790747129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790747129 |
| Entity Type | Individual |
| Full Name | DR. ALLEN C. WEGENER |
| Credential | M.D. |
| Practice Address |
910 E Houston St Ste 600 Tyler TX 75702-8369 |
| Mailing Address |
Po Box 846098 Dallas TX 75284-6098 |
| Practice Telephone | 9035262644 |
| Mailing Telephone | 9033246450 |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2016-02-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | J2410 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1178196-01 | 05 | |
| TX | BLUE SHIELD | 82736F | 01 |
| TX | RR/MEDICARE | 340018326 | 01 |
| TX | TRICARE-DOUGLAS | 75-2616977-007 | 01 |
| TX | TRICARE | 75-2616977-126 | 01 |
| Street Address |
910 E HOUSTON ST STE 600 |
| City | TYLER |
| State | TX |
| Zip Code | 75702-8369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518962299 | Nina Beth Partin | Physician Assistant | 910 E Houston St, Ste 550, Tyler, TX 75702-8369 | 2005-06-17 |
| 1396212437 | Courtney Elizabeth Clifton | Nurse Practitioner | 910 E Houston St, Tyler, TX 75702-8369 | 2018-10-26 |
| 1275991994 | Good News Medical, Pllc | Family Medicine | 910 E Houston St, Tyler, TX 75702-8369 | 2016-02-09 |
| 1154788941 | April Michelle Coursey | Nurse Practitioner | 910 E Houston St, Ste 550, Tyler, TX 75702-8369 | 2016-01-25 |
| 1417343526 | Dana R Pillans | Nurse Practitioner | 910 E Houston St, Ste 530, Tyler, TX 75702-8369 | 2015-04-15 |
| 1770973844 | Sharon L Brooks | Registered Nurse | 910 E Houston St, Ste. 550, Tyler, TX 75702-8369 | 2015-01-28 |
| 1376948620 | Kirsten Stuber | Nurse Practitioner | 910 E Houston St, Suite 100, Tyler, TX 75702-8369 | 2014-10-29 |
| 1417352931 | Texas Oncology, P.a. | Clinic/Center | 910 E Houston St, Suite 100, Tyler, TX 75702-8369 | 2014-10-27 |
| 1811241292 | Mandy Green | Nurse Practitioner | 910 E Houston St, Ste 230, Tyler, TX 75702-8369 | 2012-11-06 |
| 1902158751 | Ashley Lesniewski | Nurse Practitioner | 910 E Houston St, Suite 330, Tyler, TX 75702-8369 | 2012-10-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
| 1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
| 1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
| 1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
| 1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
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| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720275043 | Steven Bruce Roberts | Urology | 1017 E Idel St, Tyler, TX 75701-2025 | 2007-10-01 |
| 1861572968 | Urology Tyler, Pa | Urology | 700 Olympic Plaza Cir Ste 700, Tyler, TX 75701-1954 | 2006-10-16 |
| 1821434630 | Ryan Webster Tubre | Urology | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2013-05-20 |
| 1699074351 | William Riddick Armstrong IIi | Urology | 700 Olympic Plaza Cir, Suite 700, Tyler, TX 75701-1951 | 2011-03-21 |
| 1639491301 | Robert Stephen Hillis | Urology | 1701 Devonshire Dr, Tyler, TX 75703-2408 | 2010-02-23 |
| 1952440992 | Burkitt W Jensen | Urology | 910 E Houston St, Ste 600, Tyler, TX 75702-8369 | 2007-02-06 |
| 1093731788 | William Bruce Harrell | Urology | 910 E Houston St, Ste 600, Tyler, TX 75702-8369 | 2006-07-14 |
| 1043250533 | Charles T Dickson | Urology | 700 Olympic Plaza Cir, Ste 700, Tyler, TX 75701-1951 | 2006-06-07 |
| 1952341448 | James D Mcandrew | Urology | 700 Olympic Plaza Cir, Ste 700, Tyler, TX 75701-1951 | 2006-06-07 |
| 1629018122 | Mark Greenberg | Urology | 700 Olympic Plaza Cir, Ste 700, Tyler, TX 75701-1951 | 2006-06-07 |
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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.