Provider Demographics
NPI:1215291026
Name:IBE, MICHAEL C (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C
Last Name:IBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1310B PALUXY ROAD
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-5655
Mailing Address - Country:US
Mailing Address - Phone:817-579-3970
Mailing Address - Fax:817-579-3969
Practice Address - Street 1:1310B PALUXY ROAD
Practice Address - Street 2:SUITE 1400
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-5655
Practice Address - Country:US
Practice Address - Phone:817-579-3970
Practice Address - Fax:817-579-3969
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2024-08-23
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Provider Licenses
StateLicense IDTaxonomies
TXU3414207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease