MEDICARE: MICHAEL ALLEN WATKINS ATP

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
1	247200000X	Other Technician

General Provider Information

NPI Number	:	1508242025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ALLEN WATKINS ATP

Provider Business Mailing Address
First Line	:	2601 MCHALE CT
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-4468
Country	:	US
Telephone Number	:	512-834-8900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 MCHALE CT
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-4468
Country	:	US
Telephone Number	:	512-834-8900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2015
Last Update Date	:	05/22/2020

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