Provider Demographics
NPI:1538116694
Name:HEINTGES, MICHELLE LYNN (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:HEINTGES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LYNN
Other - Last Name:HOLT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12201 MERIT DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2213
Mailing Address - Country:US
Mailing Address - Phone:214-238-7888
Mailing Address - Fax:214-238-7889
Practice Address - Street 1:12201 MERIT DR
Practice Address - Street 2:SUITE 350
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2213
Practice Address - Country:US
Practice Address - Phone:214-238-7888
Practice Address - Fax:214-238-7889
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6938207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH93522Medicare UPIN
TX8B1458Medicare PIN
TXH93522Medicare UPIN