Provider Demographics
NPI:1356509673
Name:MICHAEL M KATZ, MD,PA
Entity Type:Organization
Organization Name:MICHAEL M KATZ, MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-369-9330
Mailing Address - Street 1:8220 WALNUT HILL LN
Mailing Address - Street 2:615
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4427
Mailing Address - Country:US
Mailing Address - Phone:214-369-9330
Mailing Address - Fax:214-739-6834
Practice Address - Street 1:8220 WALNUT HILL LN
Practice Address - Street 2:615
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4427
Practice Address - Country:US
Practice Address - Phone:214-369-9330
Practice Address - Fax:214-739-6834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4146332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089768801Medicaid
TX089768801Medicaid
TX0493090001Medicare NSC
TXQC0059Medicare PIN