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NPI Code Detail

MEDICARE: DANIEL B. WAGNER D.O.

MEDICARE: DANIEL B. WAGNER D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianM6450TX
2207XS0114XAdult Reconstructive Orthopaedic Surgery PhysicianM6450TX

General Provider Information

NPI Number : 1750348314
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL B. WAGNER D.O.
Provider Business Mailing Address
First Line : 2901 ACME BRICK PLZ
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-4124
Country : US
Telephone Number : 817-529-1900
Fax Number : 817-529-1910
Provider Business Practice Location Address
First Line : 2901 ACME BRICK PLZ
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-4124
Country : US
Telephone Number : 817-529-1900
Fax Number : 817-529-1910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 08/29/2025

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Directions to “ DANIEL B. WAGNER D.O.” Practice Location

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