Provider Demographics
NPI:1851394886
Name:STOREY, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:STOREY
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 1:150 FM 1959 RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-5491
Mailing Address - Country:US
Mailing Address - Phone:281-922-5550
Mailing Address - Fax:281-484-8911
Practice Address - Street 1:150 FM 1959 RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-5491
Practice Address - Country:US
Practice Address - Phone:281-922-5550
Practice Address - Fax:281-484-8911
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8383174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100106702Medicaid
TX100106702Medicaid
TXG10340Medicare UPIN