| Michael J Badlissi Md Pa | |
|
2300 Highway 365 Ste 330 Nederland TX 77627-6255 | |
| (409) 727-7342 | |
| Not Available |
| Full Name | Michael J Badlissi Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2300 Highway 365 Ste 330, Nederland, Texas |
| Authorized Official Name and Position | Michael Badlissi (MD/ PRESIDENT) |
| Authorized Official Contact | 4097277342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael J Badlissi Md Pa 2300 Highway 365 Ste 330 Nederland TX 77627-6255 Ph: (409) 727-7342 | Michael J Badlissi Md Pa 2300 Highway 365 Ste 330 Nederland TX 77627-6255 Ph: (409) 727-7342 |
| NPI Number | 1699024158 |
|---|---|
| Provider Enumeration Date | 08/30/2012 |
| Last Update Date | 10/06/2021 |
| Medicare PECOS PAC ID | 1951559301 |
|---|---|
| Medicare Enrollment ID | O20120910000859 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699024158 | NPI | - | NPPES |
| 1770710337 | Other | TX | TYPE 1 NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | P3115 (Texas) | Primary |
| Provider Name | Michael J Badlissi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770710337 PECOS PAC ID: 2860640216 Enrollment ID: I20120910000875 |
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