Provider Demographics
NPI:1336336957
Name:SPRINGFIELD, MICHELLE FARRAR (MICHELLE SPRINGFIELD)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:FARRAR
Last Name:SPRINGFIELD
Suffix:
Gender:F
Credentials:MICHELLE SPRINGFIELD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:FARRAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:3300 OCALA CT
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3647
Mailing Address - Country:US
Mailing Address - Phone:214-395-6472
Mailing Address - Fax:972-618-4234
Practice Address - Street 1:6150 INDEPENDENCE PKWY
Practice Address - Street 2:SUITE K
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4000
Practice Address - Country:US
Practice Address - Phone:214-395-6472
Practice Address - Fax:972-618-4234
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT045736174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist