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MOULTON CLINIC
NPI 1356322127
Clinic/Center - Rural Health in Moulton, TX

Active since November 09, 2005CLIA 45D0902600 · Waiver
100 S PECAN, MOULTON, TX 77975(361) 594-3824 Get Directions Write a Review

NPPES record last updated: November 2, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Moulton Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOULTON CLINIC (NPI 1356322127) is a healthcare organization registered as a rural health in Moulton, Texas and active in the NPI registry since November 2005. The organization holds a CLIA Waiver certificate valid through June 23, 2027 and lists Ralph Wagner, Md, as its authorized official.

NPPES Registry Identity

NPI1356322127
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameWAGNER MEDICAL CLINIC L.L.P.
Location Address100 S PECANMoulton, TX 77975-0238
Mailing AddressPo Box 965Shiner, TX 77984-0965 · (361) 594-3824
Phone(361) 594-3824
Organization SubpartNo
Authorized OfficialRalph WagnerMd · (361) 594-3824
Enumeration DateNovember 9, 2005
Last NPPES UpdateNovember 2, 2017
✔ NPI 1356322127 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA11615
100 S PECAN, Moulton, TX 77975
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Other Names 1

Doing Business AsMoulton Clinic

Other Identifiers 2

Medicaid063662301TX
Medicare OSCAR/certification458968TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D0902600

Wagner Medical Clinic Lab · Shiner, TX
Active · expires Jun 23, 2027
CLIA Number45D0902600
Laboratory TypeCommunity Clinic
Certificate Effective DateJune 24, 2025
Certificate Expiration DateJune 23, 2027
Laboratory DirectorWagner A. Ralph
Laboratory Phone(361) 594-3824
Laboratory LocationWagner Medical Clinic Lab124 East Walters 2nd Street, Shiner, TX 77984
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wagner Medical Clinic L.L.P.'s NPI number?

The NPI number for Wagner Medical Clinic L.L.P. is 1356322127. It was assigned to this organization in the NPPES registry on November 9, 2005. The provider is doing business as Moulton Clinic.

Where is Wagner Medical Clinic L.L.P. located?

Wagner Medical Clinic L.L.P. is located at 100 S Pecan, Moulton, TX 77975. The listed phone number is (361) 594-3824.

What is Wagner Medical Clinic L.L.P.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Wagner Medical Clinic L.L.P. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D0902600) is associated with this NPI, valid through June 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wagner Medical Clinic L.L.P. accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Wagner Medical Clinic L.L.P. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wagner Medical Clinic L.L.P. was last updated on November 2, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.