Provider Demographics
NPI:1912005695
Name:BELL, MICHELLE A (RD LD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:BELL
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:A
Other - Last Name:KERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD LD
Mailing Address - Street 1:14706 BIRCH ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-6046
Mailing Address - Country:US
Mailing Address - Phone:713-254-9459
Mailing Address - Fax:281-458-6550
Practice Address - Street 1:14706 BIRCH ARBOR CT
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-6046
Practice Address - Country:US
Practice Address - Phone:713-254-9459
Practice Address - Fax:281-458-6550
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154213601Medicaid