Provider Demographics
NPI:1346351939
Name:SHELL, MICHOU TRAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHOU
Middle Name:TRAN
Last Name:SHELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:PHUONG THAO
Other - Middle Name:DINH
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:4201 BEE CAVES RD
Mailing Address - Street 2:SUITE C-104
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-330-9016
Mailing Address - Fax:512-330-9962
Practice Address - Street 1:4201 BEE CAVES RD
Practice Address - Street 2:SUITE C-104
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-330-9016
Practice Address - Fax:512-330-9962
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202481223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics