Provider Demographics
NPI:1255749990
Name:SKELLEY, MICHAEL P (HIS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:SKELLEY
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5418 MOSSGREY LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-6995
Mailing Address - Country:US
Mailing Address - Phone:281-454-9462
Mailing Address - Fax:
Practice Address - Street 1:9953 S POST OAK RD
Practice Address - Street 2:STE. 14
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4309
Practice Address - Country:US
Practice Address - Phone:713-726-8558
Practice Address - Fax:713-726-9295
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80609237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist