Individual
DR. MICHAEL RAYNARD MAGOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6104 BROADWAY STE C-1, SAN ANTONIO, TX 78209-4553
(210) 756-0800
(210) 756-0900
Mailing address
8107 PRINCESS CT, SAN ANTONIO, TX 78209-2253
(210) 862-6064
(210) 756-0900
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J4899
TX
208D00000X
General Practice Physician
J4899
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8CR994
BCBS
TX
Enumeration date
03/21/2006
Last updated
11/10/2025
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