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Organization

MICHAEL A. BOGDAN, MD, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL ANDREW BOGDAN M.D. (PRESIDENT)
(817) 442-1236
Entity
Organization

Contact information

Practice address
410 N CARROLL AVE, SUITE 170, SOUTHLAKE, TX 76092-6455
(817) 442-1236
(817) 442-1247
Mailing address
410 N CARROLL AVE, SUITE 170, SOUTHLAKE, TX 76092-6455
(817) 442-1236
(817) 442-1247

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
M6055
TX

Other

Enumeration date
12/26/2008
Last updated
12/26/2008
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