Provider Demographics
NPI:1063513505
Name:JONES, MICHAEL WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WAYNE
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 VIRGINIA PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5409
Mailing Address - Country:US
Mailing Address - Phone:469-352-7140
Mailing Address - Fax:214-973-5205
Practice Address - Street 1:5801 VIRGINIA PKWY STE 101
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5409
Practice Address - Country:US
Practice Address - Phone:469-352-7140
Practice Address - Fax:214-973-5205
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3901207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114415603Medicaid
TX114415603Medicaid
TX00G54QMedicare ID - Type Unspecified