MEDICARE: MICHAELENE R RIBBECK N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	245103	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8Z1283	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1154354843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAELENE R RIBBECK N.P.

Provider Business Mailing Address
First Line	:	4747 BELLAIRE BLVD
Second Line	:	STE 101
City	:	BELLAIRE
State	:	TX
Zip	:	77401-4515
Country	:	US
Telephone Number	:	713-500-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	6414 FANNIN ST
Second Line	:	G150
City	:	HOUSTON
State	:	TX
Zip	:	77030-1517
Country	:	US
Telephone Number	:	713-704-2494
Fax Number	:	713-704-6260

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	08/10/2018

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