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1811095748
KACY LAMAR WAGNE
CORPUS CHRISTI, TX
NPI
1811095748
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: TX 41074)
Enumeration Date
2006-09-21
Last Update Date
2010-09-30
Business Address
Dr. KACY LAMAR WAGNE PHARM.D.
5283 OLD BROWNSVILLE RD
CORPUS CHRISTI, TX 78405-3908
Phone number: 361-806-5612
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Mailing Address
Dr. KACY LAMAR WAGNE PHARM.D.
6914 SIR PALLEAS
CORPUS CHRISTI, TX 78413-5303
Phone number:
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