Provider Demographics
NPI:1053561233
Name:MAGNOLIA WOMEN'S CARE, P.L.L.C.
Entity type:Organization
Organization Name:MAGNOLIA WOMEN'S CARE, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONCEPCION
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-748-7153
Mailing Address - Street 1:150 E SONTERRA BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4098
Mailing Address - Country:US
Mailing Address - Phone:210-748-7153
Mailing Address - Fax:
Practice Address - Street 1:150 E SONTERRA BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4098
Practice Address - Country:US
Practice Address - Phone:210-748-7153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty