Provider Demographics
NPI:1558323733
Name:WATKINS, MICHAEL G (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:G
Last Name:WATKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1400 N IH 35
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1926
Mailing Address - Country:US
Mailing Address - Phone:512-324-8300
Mailing Address - Fax:512-324-8301
Practice Address - Street 1:1180 SETON PKWY
Practice Address - Street 2:SUITE 450
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6178
Practice Address - Country:US
Practice Address - Phone:512-504-0860
Practice Address - Fax:512-504-0861
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2014-12-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG0265207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131766113Medicaid
TX8ET554OtherBCBS
TX131766114Medicaid
TX131766115Medicaid
TX8CN886OtherBCBS
TXP00837533OtherRAILROAD MEDICARE
TX131766112Medicaid
TX131766115Medicaid
TX8CN886OtherBCBS
TX131766112Medicaid
TX339332YMGJMedicare PIN
TXP00837533OtherRAILROAD MEDICARE