Provider Demographics
NPI:1154647337
Name:MAGNO, MYLA AFABLE (DNP APRN)
Entity type:Individual
Prefix:MISS
First Name:MYLA
Middle Name:AFABLE
Last Name:MAGNO
Suffix:
Gender:F
Credentials:DNP APRN
Other - Prefix:DR
Other - First Name:MYLA
Other - Middle Name:AFABLE
Other - Last Name:MAGNO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP
Mailing Address - Street 1:1919 HOWTH AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77051-0002
Mailing Address - Country:US
Mailing Address - Phone:713-562-3699
Mailing Address - Fax:
Practice Address - Street 1:2002 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4211
Practice Address - Country:US
Practice Address - Phone:713-562-3699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAPII7390363LP0808X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX215562401Medicaid
2609025OtherCIGNA
9114584OtherAETNA
SCP00924645OtherMEDICARE RAILROAD
SCP00924645OtherMEDICARE RAILROAD