Healthcare Provider Details

I. General information

NPI: 1144529801
Provider Name (Legal Business Name): MICHELLE CHRISTINE MUSSON MD/PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2011
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 PRESIDENT GEORGE BUSH TPKE STE 108
SACHSE TX
75048-4980
US

IV. Provider business mailing address

4650 PRESIDENT GEORGE BUSH TPKE STE 108
SACHSE TX
75048-4980
US

V. Phone/Fax

Practice location:
  • Phone: 469-715-3489
  • Fax: 469-715-3490
Mailing address:
  • Phone: 469-715-3489
  • Fax: 469-715-3490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP7819
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: