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NPI Code Detail

MEDICARE: WAGGONER AND THOMAS, INC.

MEDICARE: WAGGONER AND THOMAS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency008105TX

General Provider Information

NPI Number : 1891857124
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAGGONER AND THOMAS, INC.
Provider Business Mailing Address
First Line : 4100 E PIEDRAS DR
Second Line : SUITE 215
City : SAN ANTONIO
State : TX
Zip : 78228-1401
Country : US
Telephone Number : 210-348-8805
Fax Number : 210-745-3939
Provider Business Practice Location Address
First Line : 4100 E PIEDRAS DR
Second Line : SUITE 215
City : SAN ANTONIO
State : TX
Zip : 78228-1401
Country : US
Telephone Number : 210-348-8805
Fax Number : 210-745-3939
Authorized Official
Title or Position : CEO
Name : MS. HASKELENE THOMAS
Credential :
Telephone Number : 210-348-8805
Provider Enumeration Date : 12/14/2006
Last Update Date : 08/22/2020

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1972631844 — MS. MONICA E TREVINO LMSW
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Practice Fax: 210-745-3938

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