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NPI Code Detail

MEDICARE: MICHILLE L SEO

MEDICARE: MICHILLE L SEO
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
1332BC3200XCustomized Equipment (DME)TX

General Provider Information

NPI Number : 1932410313
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHILLE L SEO
Provider Business Mailing Address
First Line : 4008 E STAN SCHLUETER LOOP
Second Line : STE 104
City : KILLEEN
State : TX
Zip : 76542-8536
Country : US
Telephone Number : 254-699-9993
Fax Number :
Provider Business Practice Location Address
First Line : 4008 E STAN SCHLUETER LOOP
Second Line : STE 104
City : KILLEEN
State : TX
Zip : 76542-8536
Country : US
Telephone Number : 254-699-9993
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2010
Last Update Date : 06/30/2010

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Directions to “ MICHILLE L SEO ” Practice Location

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