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NPI Code Detail

MEDICARE: DICKINSON OB-GYN ASSOCIATION, P.A.

MEDICARE: DICKINSON OB-GYN ASSOCIATION, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician

General Provider Information

NPI Number : 1356463384
Entity Type Code : Organization
Provider Name (Legal Business Name) : DICKINSON OB-GYN ASSOCIATION, P.A.
Provider Business Mailing Address
First Line : 2450 S SHORE BLVD
Second Line : SUITE 215
City : LEAGUE CITY
State : TX
Zip : 77573-2994
Country : US
Telephone Number : 281-334-6875
Fax Number : 281-334-0664
Provider Business Practice Location Address
First Line : 2450 S SHORE BLVD
Second Line : SUITE 215
City : LEAGUE CITY
State : TX
Zip : 77573-2994
Country : US
Telephone Number : 281-334-6875
Fax Number : 281-334-0664
Authorized Official
Title or Position : PRESIDENT
Name : MICHAEL ANTHONY MAGLIOLO
Credential : M.D.
Telephone Number : 281-334-6875
Provider Enumeration Date : 04/03/2007
Last Update Date : 08/22/2020

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Directions to “DICKINSON OB-GYN ASSOCIATION, P.A. ” Practice Location

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