Provider Demographics
NPI:1972665545
Name:BRINKLEY, MICHELE GOLDMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:GOLDMAN
Last Name:BRINKLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:18220 STATE HIGHWAY 249
Mailing Address - Street 2:SUITE 370
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4347
Mailing Address - Country:US
Mailing Address - Phone:281-469-6667
Mailing Address - Fax:281-469-8567
Practice Address - Street 1:18220 STATE HIGHWAY 249
Practice Address - Street 2:SUITE 370
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4347
Practice Address - Country:US
Practice Address - Phone:281-469-6667
Practice Address - Fax:281-469-8567
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH7925207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE79587Medicare UPIN
89M362Medicare ID - Type Unspecified