Provider Demographics
NPI:1710098975
Name:COVERMAN, MICHAEL HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HOWARD
Last Name:COVERMAN
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 1:12201 RENFERT WAY STE 305
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5371
Mailing Address - Country:US
Mailing Address - Phone:512-279-3376
Mailing Address - Fax:512-666-3244
Practice Address - Street 1:12201 RENFERT WAY STE 305
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5371
Practice Address - Country:US
Practice Address - Phone:512-279-3376
Practice Address - Fax:512-540-8524
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0945207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AA540OtherBLUE CROSS BLUE SHIELD
B22002Medicare UPIN
TX8AA540OtherBLUE CROSS BLUE SHIELD