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NPI Code Detail

MEDICARE: DR. MICHAEL LEWIS MINTZ M.D.

MEDICARE: DR. MICHAEL LEWIS MINTZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistE5858TX
2207Y00000XOtolaryngology PhysicianE5858TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023013612
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL LEWIS MINTZ M.D.
Provider Business Mailing Address
First Line : 5959 S STAPLES ST STE 102
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78413-3844
Country : US
Telephone Number : 361-854-7000
Fax Number : 361-814-2685
Provider Business Practice Location Address
First Line : 5959 S STAPLES ST STE 102
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78413-3844
Country : US
Telephone Number : 361-854-7000
Fax Number : 361-814-2685
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 03/06/2023

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