Individual
MICHAEL T. TIMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1504 HURON TRL, PLANO, TX 75075-6824
(214) 227-2457
(214) 764-0880
Mailing address
PO BOX 2550, ROWLETT, TX 75030-2550
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00975
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA00975
STATE LICENSE
TX
Enumeration date
01/16/2007
Last updated
07/02/2020
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