Provider Demographics
NPI:1285613653
Name:HOUSE, MICHAEL A (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:HOUSE
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 1:3200 COLORADO BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6875
Mailing Address - Country:US
Mailing Address - Phone:940-331-7222
Mailing Address - Fax:
Practice Address - Street 1:3200 COLORADO BLVD STE 101
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6875
Practice Address - Country:US
Practice Address - Phone:940-331-7222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8585207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CR146OtherBCBS TX 02/01/2011
TX031324903Medicaid
TX1285613653OtherNPI
TX8X5841OtherBCBS TEXAS NUMBER
TXTXB117562OtherMEDICARE PART B EFFECT 02/01/2011
TXP00390865OtherRAILROAD MEDICARE
TXP00913306OtherRAILROAD MEDICARE EFFECT 02/01/2011
TX6484850005OtherMEDICARE NSC EFFECT 02/01/2011
TX5840300001Medicare NSC
TX6484850005OtherMEDICARE NSC EFFECT 02/01/2011
TXP00390865OtherRAILROAD MEDICARE