Magoon Private Clinic, PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MAGOON PRIVATE CLINIC, PLLC

Practice address

6104 Broadway Ste C-1
Alamo Heights, TX 78209-4553

Phone

(210) 756-0800

Fax

(210) 756-0900

NPI assigned

Oct 7, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Michael Magoon, MDNPI 1073572780

Title

Owner

Phone

(210) 862-6064

Specialties & licenses 1

Addresses

Other names 2

• Alamo Private Clinic Doing business as
• Alamo Private Clinic, PLLC Doing business as

Locations

Practitioners 1

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

• Michael Raynard Magoon, MD

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1073572780

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1669291845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8107 PRINCESS CT",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782092253",
            "telephone_number": "210-862-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6104 BROADWAY STE C-1",
            "city": "ALAMO HEIGHTS",
            "state": "TX",
            "postal_code": "782094553",
            "telephone_number": "210-756-0800",
            "fax_number": "210-756-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGOON PRIVATE CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-06",
        "status": "A",
        "authorized_official_last_name": "MAGOON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-862-6064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alamo Private Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alamo Private Clinic, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Huntleigh at Home
• Brenda Susan Karimalis, LPC-S, NCC
• Alfred V Koutnik
• Larry R Davis M.D.
• Justin Lee
• Hijab Mumtaz Makda, PHARMD
• Raisa Nunez, LMFT
• Morgan Danielle Phelps, LPC
• Jessica Catherine Stolar, LCSW
• Ventura Business Partners LLC

• General Practice Physician in Alamo Heights, TX
• Providers in Alamo Heights, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.