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Individual

DR. MICHAEL ANTHONY MAGLIOLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2060 SPACE PARK DR STE 410, HOUSTON, TX 77058-3676
(281) 334-6875
(281) 334-0664
Mailing address
2060 SPACE PARK DR STE 410, HOUSTON, TX 77058-3676
(281) 334-6875
(281) 334-0664

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
E6133
TX
207VG0400X
Gynecology Physician
Primary
E6133
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
105811703
TX
05
105811704
TX
01
8FL150
BLUE CROSS BLUE SHIELD
TX
01
8FX367
BLUE CROSS BLUE SHIELD
TX
05
P08862321
TX
Enumeration date
07/12/2005
Last updated
08/15/2016
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