Provider Demographics
NPI:1063950459
Name:MAGNIFICAT PRIMARY CARE LLC
Entity type:Organization
Organization Name:MAGNIFICAT PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARACELI
Authorized Official - Middle Name:
Authorized Official - Last Name:AMADOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-698-2127
Mailing Address - Street 1:17833 KUYKENDAHL RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-1109
Mailing Address - Country:US
Mailing Address - Phone:832-610-7225
Mailing Address - Fax:832-698-2976
Practice Address - Street 1:17833 KUYKENDAHL RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-1109
Practice Address - Country:US
Practice Address - Phone:328-698-2127
Practice Address - Fax:832-698-2976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-06
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty