Provider Demographics
NPI:1770817900
Name:BROWN, MICHELE PILLORGE (MSPT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:PILLORGE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9433 BEE CAVE RD
Mailing Address - Street 2:BLDG 3, STE 101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-6135
Mailing Address - Country:US
Mailing Address - Phone:512-306-8007
Mailing Address - Fax:512-672-6178
Practice Address - Street 1:9433 BEE CAVE RD
Practice Address - Street 2:BLDG 3, STE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78733-6135
Practice Address - Country:US
Practice Address - Phone:512-306-8007
Practice Address - Fax:512-672-6178
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11580082251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics