Russo, Michael Anthony

Russo, Michael Anthony is an individual health care provider with primary practice located at 7000 W Plano Pkwy Ste 110 , Plano TX 75093-8467. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as his primary health care specialty. Russo, Michael Anthony can be contacted via phone (972) 306-3767.

Contact Information

Primary practice address
7000 W Plano Pkwy Ste 110 Plano TX 75093-8467
Phone: (972) 306-3767
Fax: (972) 566-8839
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X L2616 Texas

Profile Details

NPI number 1043272958
LBN Legal business name Russo, Michael Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Sep 21st, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043272958 NPPES
Texas Other 8DD556 BCBSTX
Texas MEDICAID 166239701 BCBSTX

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