Provider Demographics
NPI:1558314336
Name:PUHL, MICHAEL STEVEN (FNP)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:PUHL
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6344 DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:N RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-4762
Mailing Address - Country:US
Mailing Address - Phone:817-849-2098
Mailing Address - Fax:
Practice Address - Street 1:1823 CIRCLEVIEW DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76087-9158
Practice Address - Country:US
Practice Address - Phone:817-598-0534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX649401363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8N9369OtherBCBS
TX142471512Medicaid
TX142471509Medicaid
TXP00892588OtherRRMCARE THRU IEPOS
TX8N9369OtherBCBS
TX142471512Medicaid
P23772Medicare UPIN
TX8D9232Medicare PIN