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1902429749
MICHAEL WAYNE WAGONER
CELINA, TX
NPI
1902429749
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: TX T5488)
Enumeration Date
2020-05-27
Last Update Date
2024-06-26
Business Address
MICHAEL WAYNE WAGONER DO
1109 AZURE LN
CELINA, TX 75009-1798
Phone number: 757-971-0190
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Mailing Address
MICHAEL WAYNE WAGONER DO
1109 AZURE LN
CELINA, TX 75009-1798
Phone number: 757-971-0190
Copy
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