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NPI Code Detail

MEDICARE: DR. MICHAEL WARE HENNESSY M.D.

MEDICARE: DR. MICHAEL WARE HENNESSY M.D.
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
1207XS0117XOrthopaedic Surgery of the Spine PhysicianM8711TX

General Provider Information

NPI Number : 1770795387
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL WARE HENNESSY M.D.
Provider Business Mailing Address
First Line : 17051 DALLAS PKWY STE 400
Second Line :
City : ADDISON
State : TX
Zip : 75001-7108
Country : US
Telephone Number : 214-370-3535
Fax Number : 214-370-0004
Provider Business Practice Location Address
First Line : 17051 DALLAS PKWY STE 400
Second Line :
City : ADDISON
State : TX
Zip : 75001-7108
Country : US
Telephone Number : 214-370-3535
Fax Number : 214-370-0004
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 06/15/2022

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