Provider Demographics
NPI:1194027607
Name:MULDROW, MICHELLE JEANINE (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:JEANINE
Last Name:MULDROW
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:8711 VILLAGE DR STE 114
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5419
Mailing Address - Country:US
Mailing Address - Phone:210-436-1182
Mailing Address - Fax:210-436-1183
Practice Address - Street 1:502 MADISON OAK DR STE 160
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4086
Practice Address - Country:US
Practice Address - Phone:210-436-1182
Practice Address - Fax:210-436-1183
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP7817207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX340989YPW5Medicare UPIN