Provider Demographics
NPI:1639108624
Name:BRICKER, MICHELLE B (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:B
Last Name:BRICKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8524 HIGHWAY 6 N
Mailing Address - Street 2:BOX 342
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2103
Mailing Address - Country:US
Mailing Address - Phone:281-345-2743
Mailing Address - Fax:
Practice Address - Street 1:8524 HIGHWAY 6 N
Practice Address - Street 2:BOX 342
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2103
Practice Address - Country:US
Practice Address - Phone:281-345-2743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9818207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE58377Medicare UPIN
TX00N03QMedicare ID - Type Unspecified