Provider Demographics
NPI:1134209562
Name:CABALLERO, MICHELLE RAYE (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RAYE
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:RAYE
Other - Last Name:DALTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6621 FANNIN STREET
Mailing Address - Street 2:A3300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2303
Mailing Address - Country:US
Mailing Address - Phone:832-824-1000
Mailing Address - Fax:832-822-0752
Practice Address - Street 1:17580 IH 45 SOUTH
Practice Address - Street 2:WL-330
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384
Practice Address - Country:US
Practice Address - Phone:936-267-5000
Practice Address - Fax:832-822-0752
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1554207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176295701Medicaid
I10762Medicare UPIN
8G0199Medicare ID - Type Unspecified