Provider Demographics
NPI:1568122794
Name:JUNGMAN, MAGDALENA (OT, MA, CNT)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:JUNGMAN
Suffix:
Gender:F
Credentials:OT, MA, CNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2743 SMITH RANCH RD STE 701
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5210
Mailing Address - Country:US
Mailing Address - Phone:713-433-7406
Mailing Address - Fax:713-433-7406
Practice Address - Street 1:2743 SMITH RANCH RD STE 701
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5210
Practice Address - Country:US
Practice Address - Phone:713-433-7406
Practice Address - Fax:713-433-7406
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108850225XF0002X, 225XP0200X
TX108950225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & SwallowingGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty