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Individual

MICHAEL LAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2200 BERGQUIST DR, JBSA LACKLAND, TX 78236-9907
(210) 292-8808
Mailing address
2200 BERGQUIST DR, JBSA LACKLAND, TX 78236-9907
(210) 292-8808

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
207N00000X
Dermatology Physician
Primary
02008067A
IN
208D00000X
General Practice Physician
Primary
02008067A
IN

Other

Enumeration date
03/31/2023
Last updated
05/06/2026
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