Tetzlaff, Michael T
Tetzlaff, Michael T is an individual health care provider with primary practice located at 1515 Holcombe Blvd , Houstion TX 77030-4009. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatopathology is his primary health care specialty. Tetzlaff, Michael T can be contacted via phone (713) 792-6161.Contact Information
Primary practice address
1515 Holcombe Blvd
Houstion TX 77030-4009
Phone: (713) 792-6161
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | MT185963 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ZD0900X | N6711 | Texas |
Profile Details
| NPI number | 1053478990 |
|---|---|
| LBN Legal business name | Tetzlaff, Michael T |
| Credentials | MD, PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 2nd, 2007 |
| Last updated | Apr 10th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053478990 | NPPES |
| Texas | MEDICAID | 214426301 | |
| Texas | Other | P00881574 | |
| Texas | Other | 8CL001 |
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