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OIG exclusion detail

HAROLD WAGNER

This page shows an imported LEIE row. Verify details against the official OIG source before acting.

Imported OIG rowOfficial OIG source
NPI
1114015138
Name
HAROLD GLEN WAGNER
Address
1228 REGENTS PARK COURT, DESOTO, TX, 75115
Specialty
INTERNAL MEDICINE
Exclusion type
1128a1
Exclusion date
20120820
Reinstatement date
00000000
Waiver
00000000

Source snapshot

Imported: May 05, 2026

Rows: 83,001

Checksum: 3a10b8ee0e4691855f74ce65a5e733672474291f79ed1f7cef163328d945e9a7

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