Healthcare Provider Details

I. General information

NPI: 1932660297
Provider Name (Legal Business Name): MICHAEL NICHOLAS ARTIGUE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAEL NICHOLAS ARTIGUE MD

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S MAIN ST
FT WORTH TX
76104-4917
US

IV. Provider business mailing address

200 W MAGNOLIA AVE STE 201
FT WORTH TX
76104-7657
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone: 817-702-2977
  • Fax: 817-702-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberV1016
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: