Provider Demographics
NPI:1407142078
Name:HYNES, MICHELE RAE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:RAE
Last Name:HYNES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MICHELE
Other - Middle Name:RAE
Other - Last Name:KINCAID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:23710 WESTHEIMER PKWY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3605
Mailing Address - Country:US
Mailing Address - Phone:281-392-8385
Mailing Address - Fax:281-392-8385
Practice Address - Street 1:23710 WESTHEIMER PKWY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3605
Practice Address - Country:US
Practice Address - Phone:281-392-8385
Practice Address - Fax:281-392-8385
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist