DR. MICHAEL LEWIS GREEN JR. (NPI# 1134165566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134165566 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL LEWIS GREEN JR. |
| Credential | M.D. |
| Practice Address |
900 Jerome Street Suite 204 Fort Worth TX 76104 |
| Practice Telephone | 8177209552 |
| Practice Fax Number | 8179211830 |
| Mailing Telephone | 8177209552 |
| Mailing Fax Number | 8179211830 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2019-06-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | L7736 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 163670603 | 05 | |
| TX | BCBS | 8S2322 | 01 |
| TX | 163670602 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639636186 | Michael James Green | Specialist/Technologist | 632 Noble Ct, Grand Junction, CO 81504-6987 | 2019-02-20 |
| 1063903995 | Michael Jamiel Green | Non-emergency Medical Transport (VAN) | 3816 Schooner Trl, Chesapeake, VA 23321-3215 | 2018-05-26 |
| 1144735051 | Michael Scott Green | Emergency Medical Technician, Paramedic | 315 Heathrow Dr, Hiram, GA 30141-2341 | 2017-12-14 |
| 1861934176 | Michael Green | Student in an Organized Health Care Education/Training Program | 9 Q St Ne, Washington, DC 20002-2105 | 2016-11-17 |
| 1245789528 | Michael Monroe Green | Counselor | 1048 Jackson Ave, Sharon Hill, PA 19079-1608 | 2016-09-27 |
| 1225429251 | Michael Thomas Green | Specialist/Technologist | 1651 51st St, Sacramento, CA 95819-4503 | 2015-02-12 |
| 1003119611 | Michael T Green | Dentist | 1900 N. Roselle Rd, #401, Schaumburg, IL 60195 | 2010-12-21 |
| 1760794515 | Michael Green | Chiropractor | 5101 Bel Air St, Boise, ID 83705-2774 | 2010-07-09 |
| 1316175292 | Michael Green | Emergency Medicine | Naval Hospital Camp Pendleton 200 Mercy Circle, Oceanside, CA 92055 | 2009-06-30 |
| 1548469562 | Michael S Green | Dentist | 2244 Green Hedges Way, Ste #102, Wesley Chapel, FL 33544-8189 | 2007-07-11 |
| Street Address |
900 JEROME STREET SUITE 204 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255766952 | New Care Pharmacy, Inc. | Pharmacy | 900 Jerome Street, Suite 100, Fort Worth, TX 76104 | 2013-09-12 |
| 1225338775 | Kristin Elizabeth Kamprath | Physician Assistant | 900 Jerome Street, Suite 204, Fort Worth, TX 76104 | 2010-11-01 |
| 1225061104 | Babatunde I Dosu | Pediatrics | 900 Jerome Street, Suite 102, Fort Worth, TX 76104-3939 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093273781 | Southwest Vascular P.C. | Surgery | 4375 Booth Callaway Suite 501, Fort Worth, TX 76180 | 2019-03-12 |
| 1689102022 | Kanayochukwu J. Anya Md Facs, Pllc | Surgery | 6100 Harris Pkwy Ste 380, Fort Worth, TX 76132-4128 | 2017-05-30 |
| 1093114530 | Patel Surgical Pllc | Surgery | 909 9th Ave Ste 208, Fort Worth, TX 76104-3931 | 2014-08-21 |
| 1689918948 | Texas Health Care, P.l.l.c. | Surgery | 6100 Harris Pkwy Ste 270, Fort Worth, TX 76132-4132 | 2012-11-26 |
| 1639447832 | Henry V Birdwell Jr. | Surgery | 4204 Lakewood Dr, Fort Worth, TX 76135-2704 | 2011-12-02 |
| 1669628780 | Fort Worth Clinic Specialty Care, Pllc | Surgery | 212 Cattlebaron Park Dr, Fort Worth, TX 76108-9512 | 2008-08-08 |
| 1265694731 | Balaguru Kolandavelo Sambandam | Surgery | 3025 N Tarrant Pkwy Ste 100, Fort Worth, TX 76177-8625 | 2008-06-26 |
| 1427252378 | Arsalla Islam | Surgery | 4312 Heritage Trace Pkwy, Ste 704, Fort Worth, TX 76244-9132 | 2007-06-13 |
| 1750590485 | John Landis Birbari Jr. | Surgery | 1325 Pennsylvania Avenue, Suite 720, Fort Worth, TX 76104-2144 | 2007-05-21 |
| 1427267145 | Paul Edward Gray Jr. | Surgery | 1325 Pennsylvania Ave., Suite 720, Fort Worth, TX 76104-2144 | 2007-05-21 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.