Provider Demographics
NPI:1518928894
Name:WAGER, SHARON F (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:F
Last Name:WAGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12202 QUAIL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-2215
Mailing Address - Country:US
Mailing Address - Phone:281-251-1939
Mailing Address - Fax:281-257-2594
Practice Address - Street 1:12202 QUAIL CREEK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-2215
Practice Address - Country:US
Practice Address - Phone:281-251-1939
Practice Address - Fax:281-257-2594
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2918207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167434302Medicaid
TXI16441Medicare UPIN
TX8C2412Medicare PIN