Individual
DR. MICHAEL FREEMAN MCAULEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2224
(817) 321-0312
(817) 317-7033
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3146
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
J8664
TX
2085N0700X
Neuroradiology Physician
J8664
TX
2085N0904X
Nuclear Radiology Physician
J8664
TX
2085P0229X
Pediatric Radiology Physician
J8664
TX
2085R0202X
Diagnostic Radiology Physician
Primary
J8664
TX
2085R0204X
Vascular & Interventional Radiology Physician
J8664
TX
2085U0001X
Diagnostic Ultrasound Physician
J8664
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132163005
—
TX
01
—
J8664
TX PHYSICIANS PERMIT
TX
Enumeration date
05/18/2006
Last updated
01/24/2019
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