Provider Demographics
NPI:1871545715
Name:MAGNO, FERDINAND LYNDON Q (MD)
Entity type:Individual
Prefix:
First Name:FERDINAND LYNDON
Middle Name:Q
Last Name:MAGNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 S CLOSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-4660
Mailing Address - Country:US
Mailing Address - Phone:956-468-2999
Mailing Address - Fax:956-468-2997
Practice Address - Street 1:721 W HARRISON AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-6016
Practice Address - Country:US
Practice Address - Phone:956-247-7000
Practice Address - Fax:956-399-6331
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4567207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN4567OtherTEXAS MEDICAL LICENSE
TX212158401Medicaid
8L24156Medicare UPIN