Provider Demographics
NPI:1407952906
Name:TRBOVICH, MICHELE LEE (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:LEE
Last Name:TRBOVICH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:888 WORCESTER ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-3744
Mailing Address - Country:US
Mailing Address - Phone:617-964-6681
Mailing Address - Fax:339-686-2561
Practice Address - Street 1:2500 CITYWEST BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3000
Practice Address - Country:US
Practice Address - Phone:888-946-6681
Practice Address - Fax:888-662-0859
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2012-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1753213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176288201Medicaid
TXP00259205OtherRAILROAD
TX176288201Medicaid
TX8D9770Medicare PIN