Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nathan Waggoner

Individual provider Physical Therapy Assistant · NPI 1356177471

Nathan Waggoner is a Physical Therapy Assistant in Fort Worth, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2024
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Practice location Address checks out

11801 S Fwy
Fort Worth, TX 76115
Phone: (817) 551-2747
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2113657 (TX)

Record details

NPI number1356177471
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 13, 2024
Last updated in NPPESSeptember 13, 2024
Certification dateSeptember 9, 2024
Mailing address1017 Red Cedar Way, Burleson, TX 76028-8320

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