Provider Demographics
NPI:1477044568
Name:MAGUNJE, RATIDZO
Entity Type:Individual
Prefix:
First Name:RATIDZO
Middle Name:
Last Name:MAGUNJE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 WATERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-7476
Mailing Address - Country:US
Mailing Address - Phone:214-951-5721
Mailing Address - Fax:972-279-1370
Practice Address - Street 1:203 WATERWOOD DR
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-7476
Practice Address - Country:US
Practice Address - Phone:214-951-5721
Practice Address - Fax:972-279-1370
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health