Organization
WANDA JEANNE MICHAELS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WANDA JEANNE MICHAELS MD (MEDICAL DIRECTOR/OWNER)
(800) 689-1527
Entity
Organization
Contact information
Practice address
13646 FM 849, LINDALE, TX 75771-5052
(800) 689-1527
(800) 689-1527
Mailing address
PO BOX 519, LINDALE, TX 75771-0519
(800) 689-1527
(800) 689-1527
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
J4922
TX
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
J4922
TX
2083P0901X
Public Health & General Preventive Medicine Physician
J4922
TX
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
J4922
TX
2084F0202X
Forensic Psychiatry Physician
J4922
TX
2084P0800X
Psychiatry Physician
Primary
J4922
TX
2084P0805X
Geriatric Psychiatry Physician
J4922
TX
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
J4922
TX
208D00000X
General Practice Physician
J4922
TX
363A00000X
Physician Assistant
J4922
TX
363LA2200X
Adult Health Nurse Practitioner
J4922
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
J4922
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1774069
—
TX
Enumeration date
07/09/2006
Last updated
06/14/2016
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