Provider Demographics
NPI:1174555346
Name:O'SHEA, MICHAEL EDWARD (ATC/LAT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:EDWARD
Last Name:O'SHEA
Suffix:
Gender:M
Credentials:ATC/LAT
Other - Prefix:
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Mailing Address - Street 1:1127 LAKE ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5622
Mailing Address - Country:US
Mailing Address - Phone:281-491-6955
Mailing Address - Fax:713-743-0679
Practice Address - Street 1:3100 CULLEN BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77204-6099
Practice Address - Country:US
Practice Address - Phone:713-743-0782
Practice Address - Fax:713-743-0679
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAT02352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer