Provider Demographics
NPI:1285767681
Name:DUNCAN, MICHAEL AVERY (CCP)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:AVERY
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 KINGS PASS
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:TX
Mailing Address - Zip Code:75032-5921
Mailing Address - Country:US
Mailing Address - Phone:214-534-7708
Mailing Address - Fax:972-722-7525
Practice Address - Street 1:2221 KINGS PASS
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032-5921
Practice Address - Country:US
Practice Address - Phone:214-534-7708
Practice Address - Fax:972-722-7525
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPF0277246X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist Cardiovascular