Healthcare Provider Details

I. General information

NPI: 1003037946
Provider Name (Legal Business Name): MICHIEL R NOE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 GEORGE DIETER DRIVE SUITE A
EL PASO TX
79936
US

IV. Provider business mailing address

1440 GEORGE DIETER DRIVE SUITE A
EL PASO TX
79936
US

V. Phone/Fax

Practice location:
  • Phone: 915-591-4444
  • Fax: 915-921-9000
Mailing address:
  • Phone: 915-591-4444
  • Fax: 915-921-9000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberJ6634
License Number StateTX

VIII. Authorized Official

Name: ELIZABETH NOE
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 915-591-4444