MEDICARE: MAGILL ANESTHESIA GROUP PA

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	207L00000X	Anesthesiology Physician	H4512	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	H4512	OTHER	TX	LICENSE

General Provider Information

NPI Number	:	1740688605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAGILL ANESTHESIA GROUP PA

Provider Business Mailing Address
First Line	:	PO BOX 73265
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77273-3265
Country	:	US
Telephone Number	:	281-580-9030
Fax Number	:	281-580-2725

Provider Business Practice Location Address
First Line	:	13700 VETERANS MEMORIAL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1026
Country	:	US
Telephone Number	:	281-580-9030
Fax Number	:	281-580-2725

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LINDA MAGILL
Credential	:	M.D.
Telephone Number	:	281-580-9030

Provider Enumeration Date	:	12/09/2014
Last Update Date	:	12/09/2014

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Directions to “MAGILL ANESTHESIA GROUP PA ” Practice Location

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