Provider Demographics
NPI:1588666572
Name:J MICHAEL MORRISSEY MD PA
Entity Type:Organization
Organization Name:J MICHAEL MORRISSEY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MORRISSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-943-9222
Mailing Address - Street 1:5940 W. PARKER RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6439
Mailing Address - Country:US
Mailing Address - Phone:972-620-1700
Mailing Address - Fax:972-268-8460
Practice Address - Street 1:5940 W. PARKER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6439
Practice Address - Country:US
Practice Address - Phone:972-620-1700
Practice Address - Fax:972-268-8460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0349208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173414701Medicaid
TXI23727Medicare UPIN