Timothy J Wagner (NPI# 1851372619, PAC ID# 8628065075) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1851372619 |
| PAC ID by PECOS | 8628065075 |
| Professional Enrollment ID | I20100614000054 |
| Full Name | Timothy J Wagner |
| Organization Legal Name | SHINER MEDICAL LLP |
| Address |
124 E Wolters 2nd St Shiner TX 77984-7109 |
| Phone Number | 3615943824 |
| Gender | M |
| Graduation Year | 1991 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 0244579761 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 451346 | YOAKUM COMMUNITY HOSPITAL |
| 450235 | MEMORIAL HOSPITAL |
| 451376 | LAVACA MEDICAL CENTER |
| 450023 | CITIZENS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 100 S Pecan St, Moulton, TX 77975-0238 | 3615964675 | DRS WAGNER ANDWAGNER PA |
| 124 E Wolters 2nd St, Shiner, TX 77984-7109 | 3615943824 | SHINER MEDICAL LLP |
| 124 E Wolters 2nd St, Shiner, TX 77984-7109 | DRS WAGNER ANDWAGNER PA |
| Organization Legal Name | SHINER MEDICAL LLP |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ralph A Wagner | Family Medicine | Shiner Medical LLP | 124 E Wolters 2nd St, Shiner, TX 77984-7109 |
| Marshall C Bishop | Family Medicine | Shiner Medical LLP | 124 E Wolters 2nd St, Shiner, TX 77984-7109 |
| Street Address |
124 E WOLTERS 2ND ST |
| City | SHINER |
| State | TX |
| Zip | 77984-7109 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ralph A Wagner | Family Medicine | Shiner Medical LLP | 124 E Wolters 2nd St, Shiner, TX 77984-7109 |
| Marshall C Bishop | Family Medicine | Shiner Medical LLP | 124 E Wolters 2nd St, Shiner, TX 77984-7109 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Whitney Lee Boone | Physical Therapy | Complete Hometown Physical Therapy LLC | 105 Boehm Dr, Shiner, TX 77984-6288 |
| Terri L Mcgee | Physical Therapy | Complete Hometown Physical Therapy LLC | 105 Boehm Dr, Shiner, TX 77984-6288 |
| Dale E Seifert | Physical Therapy | Complete Hometown Physical Therapy LLC | 105 Boehm Dr, Shiner, TX 77984-6288 |
| City | SHINER |
| Zip Code | 77984 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | SHINER + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Timothy J Wagner.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.