Provider Demographics
NPI:1326289877
Name:PASTOREK, MICHELLE ELIZABETH (PHD)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:PASTOREK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:ELIZABETH
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:9307 BROADWAY ST
Mailing Address - Street 2:SUITE 323
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9765
Mailing Address - Country:US
Mailing Address - Phone:281-902-1050
Mailing Address - Fax:
Practice Address - Street 1:9307 BROADWAY ST
Practice Address - Street 2:SUITE 323
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9765
Practice Address - Country:US
Practice Address - Phone:281-902-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34308103TS0200X
TX34334103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool