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General NPI Number Information
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NPI Number | 1265700652
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Entity Type | Organization
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Legal Business Name | MICHAEL P GOLDEN MDPA
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 4100 W 15TH ST SUITE212
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City | PLANO
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State | TX
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Zip | 75093-5803
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Country | US
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Telephone | 972-596-4121
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Fax | 972-596-9679
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Provider Business Mailing Address
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Address Line | 4100 W 15TH ST SUITE212
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City | PLANO
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State | TX
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Zip | 75093-5803
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Country | US
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Telephone | 972-596-4121
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Fax | 972-596-9679
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL PAUL GOLDEN
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Credential | MD
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Telephone | 972-596-4121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | F6238
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License Number State | TX
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