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NPI Code Detail

MEDICARE: GLADYS MICHIEKA PA-C

MEDICARE:   GLADYS  MICHIEKA  PA-C
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
1363A00000XPhysician AssistantPA09789TX

General Provider Information

NPI Number : 1609251347
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLADYS MICHIEKA PA-C
Provider Business Mailing Address
First Line : 2019 N INTERSTATE 35 E
Second Line :
City : DESOTO
State : TX
Zip : 75115-2688
Country : US
Telephone Number : 844-827-1812
Fax Number :
Provider Business Practice Location Address
First Line : 2019 N INTERSTATE 35 E
Second Line :
City : DESOTO
State : TX
Zip : 75115-2688
Country : US
Telephone Number : 844-827-1812
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2015
Last Update Date : 02/27/2026

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Directions to “ GLADYS MICHIEKA PA-C” Practice Location

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