IndividualActive
Ashley Wagner
NPI 1104382936 · Sports Medicine (Preventive Medicine) Physician · Austin, TX
Provider details
- NPI number
- 1104382936
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Preventive Medicine) PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- AT5055 (TX)
Practice location
3724 Executive Center Dr Ste G10
Austin, TX 78731-1665
Phone: (512) 324-9720
Mailing address
428 Lewisville Ln
Leander, TX 78641-4046
Registry dates
- Enumerated
- 2019-02-18
- Last updated
- 2019-02-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.