Provider Demographics
NPI:1881445104
Name:DEA, MICHAEL (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:DEA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE UNIVERSITY OF TEXAS MEDICAL BRANCH
Mailing Address - Street 2:301 UNIVERSITY BLVD
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555
Mailing Address - Country:US
Mailing Address - Phone:409-266-7856
Mailing Address - Fax:
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555
Practice Address - Country:US
Practice Address - Phone:503-494-8652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program