Provider Demographics
NPI:1871064089
Name:MAGONA, AMINATA
Entity type:Individual
Prefix:
First Name:AMINATA
Middle Name:
Last Name:MAGONA
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 1:25207 LOCKSPUR DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-4300
Mailing Address - Country:US
Mailing Address - Phone:210-489-0628
Mailing Address - Fax:
Practice Address - Street 1:25207 LOCKSPUR DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-4300
Practice Address - Country:US
Practice Address - Phone:210-489-0628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant