Provider Demographics
NPI:1225011547
Name:PARISI, MICHAEL GABRIEL (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GABRIEL
Last Name:PARISI
Suffix:
Gender:M
Credentials:DO
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 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:254-724-8800
Mailing Address - Fax:
Practice Address - Street 1:2201 S CLEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4110
Practice Address - Country:US
Practice Address - Phone:254-526-7523
Practice Address - Fax:254-200-4099
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4491207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00FS04OtherBLUE CROSS BLUE SHIELD
TX123108601Medicaid
TX752339303OtherHUMANA/MILITARY-TRICARE
TX83253OtherSCOTT & WHITE PLAN
TX00FS04Medicare PIN
TX752339303OtherHUMANA/MILITARY-TRICARE