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Tara Wagner
NPI 1487037404 · on the registry since 2015 · sole proprietor
Practice
- Address
- 6318 Richmond Ave Unit 4201
Dallas, TX 75214 - Phone
- (903) 312-8397
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Licence states on file
- TX
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-05-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas