Organization Active NPI

Magnolia Medical & Aesthetics

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1477039154
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MAGNOLIA MEDICAL & AESTHETICS
Practice address
19141 Stone Oak Parkway Suite 504
San Antonio, TX 78258-3374
Phone
(210) 600-3335
Fax
(210) 600-3387
NPI assigned
Jul 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Authorized official

Name
Roxie McNabb
Title
Office Manager
Phone
(281) 222-3068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

19141 Stone Oak Parkway Suite 504
San Antonio, TX 78258-3374

Mailing address

19141 Stone Oak Parkway Suite 504
San Antonio, TX 78258-3374
Phone (210) 600-3335

National Provider Directory

National Provider Directory

Locations

19141 Stone Oak Pkwy
Ste 504
San Antonio, TX 78258
Phone (210) 600-3335

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1477039154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19141 STONE OAK PARKWAY SUITE 504",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583374",
            "telephone_number": "210-600-3335",
            "fax_number": "210-600-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19141 STONE OAK PARKWAY SUITE 504",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583374",
            "telephone_number": "210-600-3335",
            "fax_number": "210-600-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MEDICAL & AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-16",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "MCNABB",
        "authorized_official_first_name": "ROXIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "281-222-3068"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.