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General NPI Number Information
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NPI Number | 1548688203
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Entity Type | Individual
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Provider Name | MAGARYA STEPHEN WAITARA M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2014
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 4301 GARTH RD STE 303
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City | BAYTOWN
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State | TX
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Zip | 77521-3158
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Country | US
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Telephone | 346-292-1470
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Fax | 346-292-1471
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Provider Business Mailing Address
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Address Line | 4301 GARTH RD SUITE 303
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City | BAYTOWN
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State | TX
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Zip | 77521-3153
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Country | US
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Telephone | 346-292-1470
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Fax | 346-292-1471
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 15490
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | T7764
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License Number State | TX
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