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WANDA JEANNE MICHAELS MD PA

Addiction Substance Use Disorder

Lindale, Texas

Provider NPI: 1720011091

Organization Information:
Organization Name:  WANDA JEANNE MICHAELS MD PA
Organization is not Subpart
Authorized Official:  WANDA JEANNE MICHAELS  MEDICAL DIRECTOR/OWNER  800-6891527

Practice Location:
13646 FM 849  LINDALE, TX 75771 US
Tel: 800-689-1527  Fax: 800-689-1527

Business Mailing Address:
PO BOX 519  LINDALE, TX 75771 US
Tel: 800-689-1527  Fax: 800-689-1527

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
TXJ4922
N207RA0201XPhysicians
Internal Medicine
TXJ4922
N2083P0901XPhysicians
Preventive Medicine
TXJ4922
N2084A0401XPhysicians
Psychiatry & Neurology
TXJ4922
N2084F0202XPhysicians
Psychiatry & Neurology
TXJ4922
Y2084P0800XPhysicians
Psychiatry & Neurology
TXJ4922
N2084P0805XPhysicians
Psychiatry & Neurology
TXJ4922
N2084P2900XPhysicians
Psychiatry & Neurology
TXJ4922
N208D00000XPhysicians
General Practice
TXJ4922
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
TXJ4922
N363LA2200XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
TXJ4922
N363LP0808XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
TXJ4922

Other Provider Identifiers:

IssuerNumberStateType
1774069TX05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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