Provider Demographics
NPI:1366949208
Name:MICHAEL L ASHLEY C. PED
Entity type:Organization
Organization Name:MICHAEL L ASHLEY C. PED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LEO
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:C PED
Authorized Official - Phone:214-702-8812
Mailing Address - Street 1:3301 GLENSHIRE DR APT 3202
Mailing Address - Street 2:
Mailing Address - City:BALCH SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75180-5226
Mailing Address - Country:US
Mailing Address - Phone:214-702-8812
Mailing Address - Fax:214-291-9576
Practice Address - Street 1:3301 GLENSHIRE DR APT 3202
Practice Address - Street 2:
Practice Address - City:BALCH SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75180-5226
Practice Address - Country:US
Practice Address - Phone:214-702-8812
Practice Address - Fax:214-291-9576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-08
Last Update Date:2018-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies