Individual
MICHAEL JOSEPH WILLENBORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5000 LONG PRAIRIE RD, FLOWER MOUND, TX 75028
(972) 420-1776
(972) 436-6996
Mailing address
5000 LONG PRAIRIE RD, FLOWER MOUND, TX 75028-2783
(972) 420-1776
(972) 436-6996
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
L3525
TX
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
L3525
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194933101
—
TX
01
—
8W8230
BLUECROSS
TX
01
—
P00602966
RAILROAD MEDICARE
TX
Enumeration date
08/18/2006
Last updated
07/26/2018
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