Provider Demographics
NPI:1205643517
Name:NOEL, MICHELE TRUDY
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:TRUDY
Last Name:NOEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11104 W AIRPORT BLVD STE 141
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3040
Mailing Address - Country:US
Mailing Address - Phone:281-310-5723
Mailing Address - Fax:254-268-8283
Practice Address - Street 1:11104 W AIRPORT BLVD STE 141
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3040
Practice Address - Country:US
Practice Address - Phone:281-310-5723
Practice Address - Fax:254-268-8283
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician