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Contact Information

STACY L WAGNER, RD LD
110 MEMORIAL HOSPITAL DR.
HUNTSVILLE, TX77340
 Phone: 936-291-4525
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for STACY L WAGNER · (Female)

NPI # 1932205242
Status Active
Credentials RD LD
Entity Individual
Enumeration date 09/15/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • TX License # DT04058
Hospital affiliation(s) Not Available
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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