Provider Demographics
NPI:1073503447
Name:SZE, MICHAEL JOHN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:SZE
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:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75461-0100
Mailing Address - Country:US
Mailing Address - Phone:903-783-1282
Mailing Address - Fax:903-783-1251
Practice Address - Street 1:3015 NE LOOP 286
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-3433
Practice Address - Country:US
Practice Address - Phone:903-785-5500
Practice Address - Fax:903-784-0970
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL47422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G2808OtherBCBS
TX153967801Medicaid
TXB010OtherCHAMPUS
TX153967802Medicaid
TXB010OtherCHAMPUS
TX153967802Medicaid
TXTXB148774Medicare PIN