MEDICARE: MICHAEL HUELA PA

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	363A00000X	Physician Assistant	PA04829	TX
2	363AM0700X	Medical Physician Assistant	PA 04829	TX
3	363A00000X	Physician Assistant	04829	TX

General Provider Information

NPI Number	:	1619962388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL HUELA PA

Provider Business Mailing Address
First Line	:	5716 ROCKPORT LN
Second Line	:
City	:	HALTOM CITY
State	:	TX
Zip	:	76137-2125
Country	:	US
Telephone Number	:	512-545-8218
Fax Number	:

Provider Business Practice Location Address
First Line	:	454 N JIM WRIGHT FWY
Second Line	:
City	:	WHITE SETTLEMENT
State	:	TX
Zip	:	76108-1437
Country	:	US
Telephone Number	:	682-703-4505
Fax Number	:	682-703-4510

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

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	02/11/2025

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Directions to “ MICHAEL HUELA PA” Practice Location

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