MAGNIFICENT ADVANCED AESTHETICS PLLC NPI 1790417541

NPI Information

  • NPI: 1790417541
  • Provider Name: MAGNIFICENT ADVANCED AESTHETICS PLLC
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: MAGNIFICENT ADVANCED AESTHETICS PLLC
  • Address: 333 E BETHANY DR STE J130
    ALLEN, TX
    ZIP 75002
  • Phone: (972) 741-0484

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NPI Details

MAGNIFICENT ADVANCED AESTHETICS PLLC is a primary care nurse practitioner in Allen, TX. MAGNIFICENT ADVANCED AESTHETICS PLLC NPI is 1790417541. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Magnificent Advanced Aesthetics Pllc.

The provider's business location address is:

333 E BETHANY DR STE J130
ALLEN, TX
ZIP 75002-826
Phone: (972) 741-0484

The provider's authorized official is Mireya Liss .
The authorized official title is Ceo and has the following contact phone number (972) 741-0484.

The enumeration date for this NPI number is 6/29/2022 and was last updated on 11/16/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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