Provider Demographics
NPI:1669476487
Name:ATTAS, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:ATTAS
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:PO BOX 21327
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76702-1327
Mailing Address - Country:US
Mailing Address - Phone:254-399-5400
Mailing Address - Fax:254-772-8669
Practice Address - Street 1:7125 NEW SANGER AVENUE
Practice Address - Street 2:STE A
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-4054
Practice Address - Country:US
Practice Address - Phone:254-399-5400
Practice Address - Fax:254-772-8669
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0792207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX060013505OtherRAILROAD MEDICARE
TX90233OtherSWHP
TX74178408876712A006OtherTRICARE
TX132341203Medicaid
TX816587OtherBLUE CROSS
TX100348101OtherFIRSTCARE
TX4341269OtherAETNA
TX116341305OtherUNITED HEALTHCARE
TX132341205Medicaid
TX757637OtherFIRSTHEALTH
TX4341269OtherAETNA
TX816587Medicare PIN
TX116341305OtherUNITED HEALTHCARE
TX757637OtherFIRSTHEALTH
TXB21010Medicare UPIN
TX132341205Medicaid