Individual
CHRISTINA MARIE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1912 BLUEBONNET DR, FORT WORTH, TX 76111-1603
(817) 807-3876
Mailing address
1912 BLUEBONNET DR, FORT WORTH, TX 76111-1603
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/11/2025
Last updated
07/11/2025
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