Provider Demographics
NPI:1558669234
Name:KLEIN, MAGDALENA JOHANA (PA)
Entity Type:Individual
Prefix:MISS
First Name:MAGDALENA
Middle Name:JOHANA
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:205 W WINDCREST ST STE 230
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4478
Mailing Address - Country:US
Mailing Address - Phone:830-990-9994
Mailing Address - Fax:830-990-9763
Practice Address - Street 1:205 W WINDCREST ST STE 230
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4478
Practice Address - Country:US
Practice Address - Phone:830-990-2854
Practice Address - Fax:844-362-7426
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07183363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX279969YNQ4Medicare PIN