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Individual

BRENT D MICHENER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3270 JOE BATTLE BLVD, SUITE 205, EL PASO, TX 79938-2639
(915) 855-2400
(915) 855-2401
Mailing address
3270 JOE BATTLE BLVD, SUITE 205, EL PASO, TX 79938-2639
(915) 855-2400
(915) 855-2401

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M7798
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M7798
TEXAS MEDICAL LICENSE
TX
Enumeration date
05/18/2007
Last updated
03/11/2013
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