Individual
MAGED M MINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18626 HARDY OAK BLVD, STE 230, SAN ANTONIO, TX 78258-4210
(210) 402-6561
(210) 402-6815
Mailing address
PO BOX 461425, SAN ANTONIO, TX 78246-1425
(210) 402-6561
(210) 402-6815
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
K8345
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
K8345
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119263504
—
TX
Enumeration date
09/01/2005
Last updated
10/02/2024
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