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General NPI Number Information
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NPI Number | 1437319266
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Entity Type | Individual
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Provider Name | TODD KEITH MAGRO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 3551 ROGER BROOKE DR
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City | JBSA FT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 726-228-0297
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Fax | 210-539-9400
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Provider Business Mailing Address
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Address Line | 1708 OLD TROLLEY RD
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8076
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Country | US
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Telephone | 843-285-8555
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Fax | 843-285-8657
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 30991
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | 30991
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License Number State | SC
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