Michael Hazel, RN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Navasota, TX
NPI 1750376307 · NPPES record last updated Oct 29, 2014
Key facts
- NPI
- 1750376307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 625218 (TX)
- Practice address
- 204 Brosig Ave
Navasota, TX 77868-3102 - Phone
- (936) 825-6185
- Fax
- (936) 825-6186
- NPI assigned
- Sep 20, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040712000602 | TX | Practitioner - Nurse Practitioner | 2668450206 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 625218 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John E Pinkstaff M D PLLC | Current |
Accepting new patients | |
| Acs Primary Care Physicians Southwest, PA | Family | Current |
Accepting new patients |
| Brazos Emergency Physicians, PA | Past | Accepting new patients | |
| Traditions Emergency Medicine PA | Past | Accepting new patients | |
| St Joseph Physician Associates | Past | Accepting new patients |
Locations
193 Interstate 45 S
Ste 800
Huntsville, TX 77340
Phone (936) 570-2626
2901 4th St
Longview, TX 75605
Phone (281) 371-1800
333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190
Interoperability endpoints
- michael.hazel.1@22902.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 625218 | TX | Yes |
Addresses
Primary practice location
204 Brosig Ave
Navasota, TX 77868-3102
Mailing address
204 Brosig Ave
Navasota, TX 77868-3102
Phone (936) 825-6185
Other providers in Navasota, TX
- Christina Marie Golembiewski
- Allen Wayne Greenwood
- David Lee Griffith
- Patricia A Griffith
- Lisa Gibbs Hall
- Sterling C Hickson
- House of Stars LLC
- Lee Ann Howell Loup
- J & L Medical PLLC
- Jaime C Benton MD PA
All providers in Navasota, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.