Healthcare Provider Details
I. General information
NPI: 1710273578
Provider Name (Legal Business Name): MICHAIL MAGARAKIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/21/2011
Last Update Date: 07/01/2022
Certification Date: 07/01/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1224 3RD ST STE 1
CORPUS CHRISTI TX
78404-2354
US
IV. Provider business mailing address
1224 3RD ST STE 1
CORPUS CHRISTI TX
78404-2354
US
V. Phone/Fax
- Phone: 361-854-0201
- Fax:
- Phone: 361-854-0201
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | T4970 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: