Provider Demographics
NPI:1639233943
Name:ENGHARDT, MICHAELE H (MD)
Entity type:Individual
Prefix:
First Name:MICHAELE
Middle Name:H
Last Name:ENGHARDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MICHAELE
Other - Middle Name:
Other - Last Name:ENGHARDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2134
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-3602
Mailing Address - Country:US
Mailing Address - Phone:210-445-7370
Mailing Address - Fax:
Practice Address - Street 1:2813 S MAYHILL ROAD
Practice Address - Street 2:INTEGRITY TRANSITIONAL HOSPITAL
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208
Practice Address - Country:US
Practice Address - Phone:210-445-7370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9671207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036287304Medicaid
TX036287304Medicaid
TX8J1262Medicare PIN