Basic Information
| Provider Information | |||||||||
| NPI: | 1962519439 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORRIS | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1903 PITTS RD | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774061352 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8325776887 | ||||||||
| FaxNumber: | 8325776887 | ||||||||
| Practice Location | |||||||||
| Address1: | 7101 W GRAND PKWY S | ||||||||
| Address2: | SUITE 180 | ||||||||
| City: | RICHMOND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774078660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323042309 | ||||||||
| FaxNumber: | 7134397995 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2006 | ||||||||
| LastUpdateDate: | 01/13/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA04577 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.