Provider Demographics
NPI:1760484349
Name:MAGEE, WENDY C (MD)
Entity Type:Individual
Prefix:PROF
First Name:WENDY
Middle Name:C
Last Name:MAGEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4419 CRENSHAW RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-3628
Mailing Address - Country:US
Mailing Address - Phone:281-991-5944
Mailing Address - Fax:281-991-6849
Practice Address - Street 1:4419 CRENSHAW RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-3628
Practice Address - Country:US
Practice Address - Phone:281-991-5944
Practice Address - Fax:281-991-6849
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9519207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX41931901Medicaid
TX41931901Medicaid
83280KMedicare ID - Type Unspecified