Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | K2867 | TX |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | K2867 | TX |
NPI | 1225053622 |
---|---|
Provider Name | Dr. Michael E. Carley |
First Address | Dallas, TX 75204 |
Second Address | Dallas, TX 75204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 17/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
153641901 | (05) | TX |
153641903 | (05) | TX |
153641904 | (05) | TX |
153641905 | (05) | TX |
153641906 | (05) | TX |
8696B7 | (02) | TX |
8G0554 | BCBS (01) | TX |
G94416 | (02) | |
TXB100123 | (02) |