Provider Demographics
NPI:1770795387
Name:HENNESSY, MICHAEL WARE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WARE
Last Name:HENNESSY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:17051 DALLAS PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-7108
Mailing Address - Country:US
Mailing Address - Phone:214-370-3535
Mailing Address - Fax:214-370-0004
Practice Address - Street 1:17051 DALLAS PKWY STE 400
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-7108
Practice Address - Country:US
Practice Address - Phone:214-370-3535
Practice Address - Fax:214-370-0004
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2022-06-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM8711207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX363408YTAKMedicare PIN