Provider Demographics
NPI:1427034875
Name:TRICE, MICHAEL EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EDWARD
Last Name:TRICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 ASPEN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-6602
Mailing Address - Country:US
Mailing Address - Phone:844-378-7423
Mailing Address - Fax:281-547-7187
Practice Address - Street 1:1315 ST JOSEPH PKWY STE 1004
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8231
Practice Address - Country:US
Practice Address - Phone:844-378-7423
Practice Address - Fax:281-547-7187
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7586207X00000X
MDD64241207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
200056503OtherRR MEDICARE
MD410237100Medicaid
416231OtherHEALTHLINK
5823149OtherBCBS
1290550001OtherADMINISTER FEDERAL
IL036101484Medicaid
133651800OtherDEPT OF LABOR
5823149OtherBCBS
1290550001OtherADMINISTER FEDERAL