Provider Demographics
NPI:1497783849
Name:SIMPSON, MICHAEL HOMER (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HOMER
Last Name:SIMPSON
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 1:1700 MURCHISON DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2931
Mailing Address - Country:US
Mailing Address - Phone:915-544-3254
Mailing Address - Fax:915-544-1203
Practice Address - Street 1:1700 MURCHISON DR
Practice Address - Street 2:SUITE 215
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2931
Practice Address - Country:US
Practice Address - Phone:915-544-3254
Practice Address - Fax:915-544-1203
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD1052207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX034117401Medicaid
TX034117401Medicaid
TXJ933Medicare ID - Type Unspecified