Physician Compare National (NPI:1174873574)

HEALTHCARE PROVIDER: MICHAEL KEITH HEAD O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1174873574
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3577712074
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120926000820
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HEAD
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Middle Name	K
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	SOUTHERN COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	TEXAS EYE AND LASER CENTER, P.A.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7315843257
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1872 NORWOOD DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 200
	Group Practice or individual's line 2 address
City	HURST
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	760547018
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8175406060
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y