Provider Demographics
NPI:1477665727
Name:LOEB, MICHAEL DELEE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DELEE
Last Name:LOEB
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 1:4700 SETON CENTER PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5295
Mailing Address - Country:US
Mailing Address - Phone:512-439-1000
Mailing Address - Fax:512-439-1081
Practice Address - Street 1:4700 SETON CENTER PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5295
Practice Address - Country:US
Practice Address - Phone:412-439-1000
Practice Address - Fax:512-439-1081
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX519521207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00735009OtherMEDICARE RAILROAD
TX192940803Medicaid
TX8L1980Medicare PIN
TXI71588Medicare UPIN
TX192940803Medicaid
TX0366280007Medicare NSC
TX0366280005Medicare NSC
TX0366280008Medicare NSC
TX8J3559Medicare PIN
TXP00735009OtherMEDICARE RAILROAD
TX0366280002Medicare NSC