Provider Demographics
NPI:1194728154
Name:LAGRONE, MICHAEL O (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:O
Last Name:LAGRONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 COULTER DRIVE
Mailing Address - Street 2:BUILDING B
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4121
Mailing Address - Country:US
Mailing Address - Phone:806-354-2529
Mailing Address - Fax:806-354-2956
Practice Address - Street 1:1600 S COULTER ST STE B
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-0703
Practice Address - Country:US
Practice Address - Phone:806-354-2529
Practice Address - Fax:806-354-2956
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6852207XS0114X, 207XS0117X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1593238-01Medicaid
TXE74816Medicare UPIN
TX00518VMedicare ID - Type Unspecified