Provider Demographics
NPI:1184823882
Name:MYERS, MICHAEL D (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:400 SW 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-8246
Mailing Address - Country:US
Mailing Address - Phone:940-328-6422
Mailing Address - Fax:940-328-6523
Practice Address - Street 1:202 SW 25TH AVE STE 1200
Practice Address - Street 2:
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-8461
Practice Address - Country:US
Practice Address - Phone:940-463-7229
Practice Address - Fax:940-763-7232
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2020-08-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXS6258208800000X
GA64613208800000X
AL37287208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology