Organization
MIKEAL LOVE, M.D, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKEAL ROBERT LOVE M.D. (PRESIDENT)
(512) 476-9699
Entity
Organization
Contact information
Practice address
900 E 30TH ST, SUITE 211, AUSTIN, TX 78705-3326
(512) 476-9699
(512) 367-5799
Mailing address
900 E 30TH ST, SUITE 211, AUSTIN, TX 78705-3326
(512) 476-9699
(512) 367-5799
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
H7322
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000033QN
BCBS
TX
05
—
292934101
—
TX
01
—
8AJ644
BCBS INDIV
TX
01
—
TXB118820
MEDICARE PTAN
TX
Enumeration date
08/29/2007
Last updated
07/29/2016
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