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Individual
MICHAEL JOE WHITELEY
Active
Individual
MICHAEL JOE WHITELEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F2109
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032573001
—
TX
01
—
0718145
NAIS #
TX
01
—
45DO8899310
CLIA #
TX
01
—
F2109
STATE LICENSE
TX
01
—
H0048255
DPS #
TX
Enumeration date
09/12/2005
Last updated
03/07/2023
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