Provider Demographics
NPI:1053578211
Name:DR. MICHAEL V. DOYLE MD PA
Entity type:Organization
Organization Name:DR. MICHAEL V. DOYLE MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGDA
Authorized Official - Middle Name:N
Authorized Official - Last Name:MAKINTUBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-368-3760
Mailing Address - Street 1:8220 WALNUT HILL LN
Mailing Address - Street 2:SUITE 606
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4427
Mailing Address - Country:US
Mailing Address - Phone:214-368-3760
Mailing Address - Fax:214-739-3534
Practice Address - Street 1:8220 WALNUT HILL LN
Practice Address - Street 2:SUITE 606
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4427
Practice Address - Country:US
Practice Address - Phone:214-368-3760
Practice Address - Fax:214-739-3534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2639207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC15386Medicare UPIN