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General NPI Number Information
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NPI Number | 1598815748
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Entity Type | Individual
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Provider Name | MICHAEL ERNEST JOHN ARCHULETA M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1100 LAKEWAY DR STE 101
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City | LAKEWAY
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State | TX
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Zip | 78734-4480
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Country | US
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Telephone | 512-413-7500
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Fax | 512-266-4646
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Provider Business Mailing Address
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Address Line | PO BOX 340639 1100 LAKEWAY DRIVE, SUITE 101
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City | AUSTIN
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State | TX
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Zip | 78734-0011
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Country | US
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Telephone | 512-413-7500
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Fax | 512-266-4646
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H9491
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 209800000X
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Taxonomy Name | Legal Medicine (M.D./D.O.) Physician
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License Number | H9491
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License Number State | TX
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