Provider Demographics
NPI:1063030666
Name:MAGENTA HEALTH, INC
Entity Type:Organization
Organization Name:MAGENTA HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICS
Authorized Official - Prefix:
Authorized Official - First Name:HEID
Authorized Official - Middle Name:
Authorized Official - Last Name:DEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-938-0151
Mailing Address - Street 1:646 S. FLORES ST
Mailing Address - Street 2:MAGENTA HEALTH
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78204
Mailing Address - Country:US
Mailing Address - Phone:210-938-7694
Mailing Address - Fax:
Practice Address - Street 1:3922 WISEMAN BLVD BLDG 1
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1668
Practice Address - Country:US
Practice Address - Phone:210-938-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center