Provider Demographics
NPI:1417627746
Name:MICHAEL J MCKENNA D.O. P.A.
Entity Type:Organization
Organization Name:MICHAEL J MCKENNA D.O. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ZENAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-621-4981
Mailing Address - Street 1:4970 N EXPRESSWAY STE A
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-4269
Mailing Address - Country:US
Mailing Address - Phone:956-621-4981
Mailing Address - Fax:956-621-4994
Practice Address - Street 1:4970 N EXPRESSWAY STE A
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-4269
Practice Address - Country:US
Practice Address - Phone:956-621-4981
Practice Address - Fax:956-621-4994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty