Provider Demographics
NPI:1477383677
Name:WARNER, RACHEL WAGSTAFF (MD, MPH, MS)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:WAGSTAFF
Last Name:WARNER
Suffix:
Gender:F
Credentials:MD, MPH, MS
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:GLENN
Other - Last Name:WAGSTAFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH, MS
Mailing Address - Street 1:4512 FAIRWAY AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-1605
Mailing Address - Country:US
Mailing Address - Phone:325-260-9568
Mailing Address - Fax:
Practice Address - Street 1:5200 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7709
Practice Address - Country:US
Practice Address - Phone:214-590-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10089203207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology