Provider Demographics
NPI:1003037946
Name:MICHIEL R NOE MD PA
Entity Type:Organization
Organization Name:MICHIEL R NOE MD PA
Other - Org Name:SUN CITY WOMEN'S HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:NOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-591-4444
Mailing Address - Street 1:1440 GEORGE DIETER DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936
Mailing Address - Country:US
Mailing Address - Phone:915-591-4444
Mailing Address - Fax:915-921-9000
Practice Address - Street 1:1440 GEORGE DIETER DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936
Practice Address - Country:US
Practice Address - Phone:915-591-4444
Practice Address - Fax:915-921-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6634173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1306845417Medicaid
TX118373305Medicaid