Provider Demographics
NPI:1245267236
Name:KHOO, MICHELLE S (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:S
Last Name:KHOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 S FM 51 STE 202
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3600
Mailing Address - Country:US
Mailing Address - Phone:940-626-0108
Mailing Address - Fax:940-757-0625
Practice Address - Street 1:1713 S FM 51 STE 202
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3642
Practice Address - Country:US
Practice Address - Phone:940-626-0108
Practice Address - Fax:940-757-0625
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2010-0511207R00000X, 207RC0000X, 207RC0001X
TXU1313207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGOtherBCBS
TXPENDINGMedicaid