Provider Demographics
NPI:1851304398
Name:TRAUDT, MAGDALENA C (MD)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:C
Last Name:TRAUDT
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 1:1202 E SONTERRA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4842
Mailing Address - Country:US
Mailing Address - Phone:210-654-4066
Mailing Address - Fax:210-654-9134
Practice Address - Street 1:1202 E SONTERRA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4842
Practice Address - Country:US
Practice Address - Phone:210-654-4066
Practice Address - Fax:210-654-9134
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9724207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122039405Medicaid
TX8694B0OtherBLUE CROSS BLUE SHIELD
TX8694B0OtherBLUE CROSS BLUE SHIELD
TX8694B0Medicare PIN