Individual
DR. KRISTOFER ROSS WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
L5174
TX
208800000X
Urology Physician
MD036057
DC
Other
Enumeration date
06/06/2006
Last updated
01/26/2022
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