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Individual

DR. MICHAEL JOHN KACAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
6001 34TH ST SPC 164, LUBBOCK, TX 79407-3106
(817) 219-0148
Mailing address
6001 34TH ST SPC 164, LUBBOCK, TX 79407-3106
(817) 219-0148

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA03371
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2242884
UNITEDHEALTHCARE
TX
01
8N4110
BC/BS
TX
01
9B847A
HEALTHSMART PPO
TX
01
P00137141
MEDICARE RAILROAD
TX
Enumeration date
01/27/2006
Last updated
02/15/2024
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