Individual
MICHAEL T. MONROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA04464
TX
363AS0400X
Surgical Physician Assistant
PA04464
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
818N32
BCBS
TX
01
—
PA04464
STATE LICENSE
TX
Enumeration date
03/13/2007
Last updated
12/12/2013
Update your record
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