Individual
MR. NICHOLAS J. WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7900 FM 1826, BLDG. 1, STE. 220, AUSTIN, TX 78737
(512) 288-9669
(512) 498-0317
Mailing address
7900 FM 1826, BLDG. 1, STE. 220, AUSTIN, TX 78737
(512) 288-9669
(512) 498-0317
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
N9977
TX
Other
Enumeration date
06/12/2008
Last updated
02/10/2015
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