Individual
DR. CONNOR WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
(210) 292-0515
Mailing address
1940 CARSWELL AVE BLDG 7002, JBSA LACKLAND, TX 78236-5514
(210) 292-0515
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34103
NE
Other
Enumeration date
06/17/2020
Last updated
08/18/2023
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