Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | D86505 | MD |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | S1864 | TX |
NPI | 1053653360 |
---|---|
Provider Name | Dr. Stuart Michnick |
First Address | Denton, TX 76201-5144 |
Second Address | Denton, TX 76201-5144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2013 |
Last Update Date | 20/08/2019 |