Provider Demographics
NPI:1205030806
Name:BRISCOE, MICHAEL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:BRISCOE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10740 N GESSNER RD STE 310
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1240
Mailing Address - Country:US
Mailing Address - Phone:281-897-0416
Mailing Address - Fax:800-876-1456
Practice Address - Street 1:1501 RIVER POINTE DR STE 120
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2860
Practice Address - Country:US
Practice Address - Phone:936-539-4700
Practice Address - Fax:800-535-3218
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2022-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN5592207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094010801OtherGROUP MEDICAID NUMBER
TX00J21AOtherGROUP MEDICARE NUMBER