Provider Demographics
NPI:1306827951
Name:NERET, MICHAEL G (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:G
Last Name:NERET
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 86
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77404-0086
Mailing Address - Country:US
Mailing Address - Phone:979-244-2007
Mailing Address - Fax:979-244-1991
Practice Address - Street 1:1809 MERLIN ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-3131
Practice Address - Country:US
Practice Address - Phone:979-244-2007
Practice Address - Fax:979-244-1991
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4832207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154730901Medicaid
TX00274HMedicare ID - Type Unspecified
TX154730901Medicaid