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Contact Information

KEITH A WAGUESPACK, MD
2021 N MACARTHUR BLVD STE 450
IRVING, TX75061
 Phone: 866-367-8768
 Fax: 817-541-9301
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Urology

208800000X 34 Physician/Urology
Indicates primary specialty

NPI Profile & details for KEITH A WAGUESPACK · (Male)

NPI # 1124014659
Status Active
Credentials MD
Entity Individual
Enumeration date 09/20/2005
Last updated 07/17/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • TX License # L7918
  • TX Medicaid 165039201
  • TX Medicaid 165039202
  • TX Medicaid 165039203
  • TX Medicaid 165039204
  • TX Medicaid 165039205
Hospital affiliation(s)
  • BAYLOR MEDICAL CENTER AT IRVING - (Acute Care)
    1901 N MACARTHUR BLVD
    IRVING, TX 75061
  • IRVING COPPELL SURGICAL HOSPITAL LLP - (Acute Care)
    400 WEST INTERSTATE 635 SUITE 101
    IRVING, TX 75063
  • LAS COLINAS MEDICAL CENTER - (Acute Care)
    6800 N MACARTHUR BLVD
    IRVING, TX 75039
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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