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NPI Code Detail

MEDICARE: DR. MICHAEL ANTHONY MAGLIOLO M.D.

MEDICARE: DR. MICHAEL ANTHONY MAGLIOLO 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
1174400000XSpecialistE6133TX
2207VG0400XGynecology PhysicianE6133TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28FL150OTHERTXBLUE CROSS BLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
58FX367OTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1801894928
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL ANTHONY MAGLIOLO M.D.
Provider Business Mailing Address
First Line : 2060 SPACE PARK DR STE 410
Second Line :
City : HOUSTON
State : TX
Zip : 77058-3676
Country : US
Telephone Number : 281-334-6875
Fax Number : 281-334-0664
Provider Business Practice Location Address
First Line : 2060 SPACE PARK DR STE 410
Second Line :
City : HOUSTON
State : TX
Zip : 77058-3676
Country : US
Telephone Number : 281-334-6875
Fax Number : 281-334-0664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 08/15/2016

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