Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | L3168 | TX |
Y | 2086S0105X | Surgery of the Hand | L3168 | TX |
NPI | 1295705986 |
---|---|
Provider Name | Dr. Gregg A Vagner |
First Address | Austin, TX 78723-1142 |
Second Address | Austin, TX 78705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 14/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
173464201 | (05) | TX |
173464202 | (05) | TX |
173464203 | (05) | TX |
H53538 | (02) | TX |