Provider Demographics
NPI:1922197458
Name:TEICHELMANN, MICHAEL P (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:TEICHELMANN
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 1:405 LONDONDERRY DR
Mailing Address - Street 2:STE 105
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7920
Mailing Address - Country:US
Mailing Address - Phone:254-776-0266
Mailing Address - Fax:254-776-2511
Practice Address - Street 1:405 LONDONDERRY DR
Practice Address - Street 2:SUITE 105
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-7924
Practice Address - Country:US
Practice Address - Phone:254-776-0266
Practice Address - Fax:254-776-2511
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL1476207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K7319Medicare PIN
TX00451TMedicare PIN
TXH59049Medicare UPIN