MEDICARE: DR. THOMAS HARRY MAGZEN D.D.S.

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	1223G0001X	General Practice Dentistry	11275	TX

General Provider Information

NPI Number	:	1629010657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS HARRY MAGZEN D.D.S.

Provider Business Mailing Address
First Line	:	11000 FONDREN RD
Second Line	:	SUITE B-105
City	:	HOUSTON
State	:	TX
Zip	:	77096-5513
Country	:	US
Telephone Number	:	713-981-9513
Fax Number	:

Provider Business Practice Location Address
First Line	:	11000 FONDREN RD
Second Line	:	SUITE B-105
City	:	HOUSTON
State	:	TX
Zip	:	77096-5513
Country	:	US
Telephone Number	:	713-981-9513
Fax Number	:

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	07/08/2007

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