Individual
MICHELLE M MCKANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2727 E SOUTHLAKE BLVD, SOUTHLAKE, TX 76092-6613
(682) 885-6000
(682) 885-6050
Mailing address
PO BOX 99213, FORT WORTH, TX 76199-0213
(682) 885-4871
(682) 885-3936
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M3640
TX
208000000X
Pediatrics Physician
Primary
M3640
TX
Other
Enumeration date
07/06/2006
Last updated
01/12/2012
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