John Van Wagoner MD

NPI #1952624157 in Denison, Texas

Provider Information

NPI Number: 1952624157
Entity Type: Organization
Organization Name: John Van Wagoner MD
Primary Specialty: Allergy & Immunology
Enumeration Date: Mar 3, 2010
Last Updated: Mar 3, 2010

Practice Location

Address: 5012 SOUTH US HIGHWAY 75
Address 2: SUITE 150
City: Denison
State: Texas
ZIP Code: 75020
Phone: (972) 398-3500

Authorized Official

Name: DR. JOHN A. VAN WAGONER, MD
Title: OWNER/PRESIDENT
Phone: (972) 398-3500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Allergy & Immunology	207K00000X	Primary

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