Provider Demographics
NPI:1598732208
Name:BROPHEY, MICHAEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:BROPHEY
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 1:14800 LANDMARK BLVD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7565
Mailing Address - Country:US
Mailing Address - Phone:972-391-1915
Mailing Address - Fax:
Practice Address - Street 1:621 N HALL ST
Practice Address - Street 2:SUITE 500
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1339
Practice Address - Country:US
Practice Address - Phone:214-841-2000
Practice Address - Fax:214-841-2015
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2264207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134653807Medicaid
TX134653802Medicaid
TX134653801Medicaid
TX134653807Medicaid
TX85G125Medicare PIN
TX82Z635Medicare PIN