Individual
DR. MICHAEL LANCE MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
H8258
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86J293
BLUE SHIELD
TX
Enumeration date
03/30/2006
Last updated
04/10/2020
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