Provider Demographics
NPI:1194239517
Name:ASHLEY, MICHAEL LEO (C PED)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:LEO
Last Name:ASHLEY
Suffix:
Gender:M
Credentials:C PED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 GLENSHIRE DR APT 3202
Mailing Address - Street 2:
Mailing Address - City:BALCH SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75180-5226
Mailing Address - Country:US
Mailing Address - Phone:214-702-8812
Mailing Address - Fax:214-291-9576
Practice Address - Street 1:3301 GLENSHIRE DR APT 3202
Practice Address - Street 2:
Practice Address - City:BALCH SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75180-5226
Practice Address - Country:US
Practice Address - Phone:214-702-8812
Practice Address - Fax:214-291-9576
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist