Provider Demographics
NPI:1962864389
Name:MCBATH, MICHAEL ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALEXANDER
Last Name:MCBATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10840 TEXAS HEALTH TRL STE 250
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6850
Mailing Address - Country:US
Mailing Address - Phone:817-750-1310
Mailing Address - Fax:817-750-1311
Practice Address - Street 1:10840 TEXAS HEALTH TRL STE 250
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6850
Practice Address - Country:US
Practice Address - Phone:817-750-1310
Practice Address - Fax:817-750-1311
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR4278207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program