MEDICARE: DR. MITCHELL J. MAGEE M.D.

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
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	G8254	TX

General Provider Information

NPI Number	:	1467440016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL J. MAGEE M.D.

Provider Business Mailing Address
First Line	:	2821 E PRESIDENT GEORGE BUSH HWY STE 404
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-4278
Country	:	US
Telephone Number	:	214-943-2200
Fax Number	:	214-943-2201

Provider Business Practice Location Address
First Line	:	2821 E PRESIDENT GEORGE BUSH HWY STE 404
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-4278
Country	:	US
Telephone Number	:	214-943-2200
Fax Number	:	214-943-2201

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	03/14/2023

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