Provider Demographics
NPI:1982605234
Name:LIFSHEN, MICHAEL SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SCOTT
Last Name:LIFSHEN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:5625 EIGER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8982
Mailing Address - Country:US
Mailing Address - Phone:512-892-7076
Mailing Address - Fax:512-899-8460
Practice Address - Street 1:912 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:STE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5264
Practice Address - Country:US
Practice Address - Phone:512-306-8360
Practice Address - Fax:512-306-8176
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2014-09-05
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Provider Licenses
StateLicense IDTaxonomies
TXH4492207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
259891YLCDMedicare PIN
E03414Medicare UPIN