Individual
GARRETT JOSEPH WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-3431
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-3431
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
136106
TX
Other
Enumeration date
12/14/2021
Last updated
06/02/2023
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