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1679562516
SCOTT BRIAN WAGNER
CORPUS CHRISTI, TX
NPI
1679562516
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: TX 655472)
Enumeration Date
2005-10-13
Last Update Date
2011-09-23
Business Address
Mr. SCOTT BRIAN WAGNER CRNA
613 ELIZABETH ST SUITE 605
CORPUS CHRISTI, TX 78404-2220
Phone number: 361-883-6211
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Mailing Address
Mr. SCOTT BRIAN WAGNER CRNA
6043 ENNIS JOSLIN RD
CORPUS CHRISTI, TX 78412-2805
Phone number: 361-992-3361
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