Provider Demographics
NPI:1487636387
Name:MINEO, MICHAEL ANGELO (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANGELO
Last Name:MINEO
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:6699 CHIMNEY ROCK RD
Mailing Address - Street 2:SUITE #102
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-5358
Mailing Address - Country:US
Mailing Address - Phone:713-668-7583
Mailing Address - Fax:713-668-5140
Practice Address - Street 1:6699 CHIMNEY ROCK RD
Practice Address - Street 2:SUITE #102
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5358
Practice Address - Country:US
Practice Address - Phone:713-668-7583
Practice Address - Fax:713-668-5140
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX0391213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121576605Medicaid
TXT14850Medicare UPIN
TX121576605Medicaid