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Ashley Christine Wagner
Sports Medicine (Preventive Medicine) Physician in Austin, Texas
NPI 1104382936

Ashley Christine Wagner is a Sports Medicine (Preventive Medicine) Physician based in Leander, TX and is specialized in Sports Medicine. Ashley Christine Wagner practices in Austin, TX. The NPI Number for Ashley Christine Wagner is 1104382936 and holds a License No. AT5055 (Texas).

The current practice location address for Ashley Christine Wagner is 3724 Executive Center Dr Ste G10, Austin, TX and can be reached out via phone at 512-324-9720.

Location: 3724 Executive Center Dr Ste G10, Austin, TX, 78641-4046
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104382936
Provider Name
Ashley Christine Wagner
Credential
Provider Entity Type
Individual
Gender
Female
Address
3724 Executive Center Dr Ste G10, Austin, TX, 78641-4046
Phone Number
512-324-9720
Fax Number
Provider Enumeration Date
02/18/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AT5055 01 TX STATE OF TEXAS LICENSURE
2000007383 01 BOARD OF CERTIFICATION
institution
Provider Business Practice Location Address Details
Address
3724 Executive Center Dr Ste G10
City
Austin
State
Texas
Zip
78731-1665
Phone Number
512-324-9720
Fax Number
person
Provider Business Mailing Address Details
Address
3724 Executive Center Dr Ste G10
City
Austin
State
Texas
Zip
78731-1665
Phone Number
512-324-9720
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Preventive Medicine
Speciality
Sports Medicine
Taxonomy
2083S0010X
License No.
AT5055 (Texas)
Definition
A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries.
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