Provider Demographics
NPI:1033311386
Name:SZUSZKIEWICZ-GARCIA, MAGDALENE MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDALENE
Middle Name:MARIA
Last Name:SZUSZKIEWICZ-GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAGDALENA
Other - Middle Name:MARIA
Other - Last Name:SZUSZKIEWICZ-GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2251 COUNTRY CLUB DRIVE
Mailing Address - Street 2:STE 131
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063
Mailing Address - Country:US
Mailing Address - Phone:682-518-1100
Mailing Address - Fax:682-518-1104
Practice Address - Street 1:2251 COUNTRY CLUB DRIVE
Practice Address - Street 2:STE 131
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063
Practice Address - Country:US
Practice Address - Phone:682-518-1100
Practice Address - Fax:682-518-1104
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2140207R00000X, 390200000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1033311386OtherMEDICARE
TX1033311386Medicaid