Individual
DR. MICHAEL G WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2900 ACME BRICK PLZ, FORT WORTH, TX 76109-4123
(817) 871-9069
(817) 871-9067
Mailing address
2900 ACME BRICK PLZ, FORT WORTH, TX 76109-4123
(817) 871-9069
(817) 871-9067
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
DO879
AL
208800000X
Urology Physician
Primary
R9886
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009984475
—
AL
Enumeration date
04/08/2006
Last updated
08/06/2019
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