Provider Demographics
NPI:1558388009
Name:COLTON, MICHAEL (FNP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:COLTON
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12036 AIRLINE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77037-1006
Mailing Address - Country:US
Mailing Address - Phone:281-447-7900
Mailing Address - Fax:281-447-3841
Practice Address - Street 1:12036 AIRLINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77037-1006
Practice Address - Country:US
Practice Address - Phone:281-447-7900
Practice Address - Fax:281-447-3841
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP109122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117961605Medicaid
TX117961601Medicaid
TX117961602Medicaid
TX117961601Medicaid
TX1558388009Medicare PIN
TX8K3887Medicare PIN
TX117961605Medicaid