Provider Demographics
NPI:1558398222
Name:ISAAC, MICHAEL GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GERARD
Last Name:ISAAC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:SUITE C339
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2571
Mailing Address - Country:US
Mailing Address - Phone:972-566-8855
Mailing Address - Fax:972-566-7509
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE C339
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2571
Practice Address - Country:US
Practice Address - Phone:972-566-8855
Practice Address - Fax:972-566-7509
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ4233207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138174102Medicaid
TX8696J1Medicare ID - Type Unspecified
TXF73987Medicare UPIN