| NPI | 1396454484 |
|---|---|
| Doing Business As | WAGONER FAMILY HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | REBEKAH M WAGONER Managing Member 936-715-5353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2022-12-19 |