Majestic Healthcare, PLLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP119783 Issued in TX

Legal business name

MAJESTIC HEALTHCARE, PLLC

Practice address

110 Eisenhower CT
Georgetown, TX 78633

Phone

(512) 364-2151

NPI assigned

Jun 15, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Kathleen McCoy, NP

Title

Owner

Phone

(512) 364-2151

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• Majestic Healthcare, PLLC Doing business as
• Advanced Medical Skin Care,LLC Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534118400000",
    "number": "1467946384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 EISENHOWER CT",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786335471",
            "telephone_number": "512-364-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EISENHOWER CT",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "78633",
            "telephone_number": "512-364-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJESTIC HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-15",
        "last_updated": "2018-08-13",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-364-2151",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP119783",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP119783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE",
            "identifier": "1679719926",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Majestic Healthcare, PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Medical Skin Care,LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Advanced Medical Skin Care,LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Erick Magallanes-Coronado, PA-C
• Andrew Glenn Mahaffey, M.D.
• Aakriti Mainali, MBBS
• Sherianne Maiorelle
• Noelle Maire
• Richard C Male Jr., D.O.
• Trisha Haelyn Mallard, DNP
• Aparna Mamidi, MACOM, L. AC, DIPL.
• Meredith Manas, LCSW
• Elham Ellie Mandavi Berenji

• Primary Care Nurse Practitioner in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.