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General NPI Number Information
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NPI Number | 1356468490
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Entity Type | Organization
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Legal Business Name | MAGUS PEDIATRIC CARDIOLOGY, PA
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 648 W CAMPBELL RD SUITE B
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City | RICHARDSON
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State | TX
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Zip | 75080-3300
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Country | US
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Telephone | 972-238-5437
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Fax | 972-238-5434
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Provider Business Mailing Address
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Address Line | PO BOX 740127
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City | DALLAS
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State | TX
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Zip | 75374-0127
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Country | US
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Telephone | 972-238-5437
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Fax | 972-238-5434
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW D FRYER
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Credential | MD
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Telephone | 972-238-5437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A45576
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | A45576
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License Number State | TX
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