Individual provider Active NPI

Michael Anthony Magliolo, M.D.

  • Gynecology Physician
  • Houston, TX
National Provider Identifier
1801894928
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
E6133 Issued in TX
Practice address
2060 Space Park Dr Ste 410
Houston, TX 77058-3676
Phone
(281) 334-6875
Fax
(281) 334-0664
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X E6133 TX
Gynecology Physician 207VG0400X E6133 TX Primary

Addresses

Primary practice location

2060 Space Park Dr Ste 410
Houston, TX 77058-3676

Mailing address

2060 Space Park Dr Ste 410
Houston, TX 77058-3676
Phone (281) 334-6875

Other identifiers 5

IdentifierTypeStateIssuer
105811704MedicaidTX
8FL150OtherTXBLUE CROSS BLUE SHIELD
P08862321MedicaidTX
105811703MedicaidTX
8FX367OtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120831000089 TX Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 2668629304 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC CurrentSince Jul 19, 2016 Accepting new patients
TMH Physician Associates PLLC CurrentSince Jul 19, 2016 Accepting new patients
Houston Methodist Specialty Physicians CurrentSince Jan 1, 2026 Accepting new patients
Dickinson OB-GYN Association, P.a. Gynecology Past Accepting new patients
Houston Methodist Past Accepting new patients

Locations

6550 Fannin St
Ste 447
Houston, TX 77030
Phone (713) 441-0633

6445 Main St
Ste 2500
Houston, TX 77030
Phone (713) 441-3150

2060 Space Park Dr
Ste 410
Houston, TX 77058
Phone (832) 783-2330

7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955

16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800

Interoperability endpoints

  • Direct secure messaging: mmagliolo66785@directhoustonmethodist.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1801894928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 SPACE PARK DR STE 410",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770583676",
            "telephone_number": "281-334-6875",
            "fax_number": "281-334-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 SPACE PARK DR STE 410",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770583676",
            "telephone_number": "281-334-6875",
            "fax_number": "281-334-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGLIOLO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "E6133",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "E6133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105811704",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8FL150",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P08862321",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105811703",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8FX367",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.