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General NPI Number Information
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NPI Number | 1356152268
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Entity Type | Organization
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Legal Business Name | MICHELLE MUSSON PLLC
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 4650 PRESIDENT GEORGE BUSH TPKE STE 108
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City | SACHSE
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State | TX
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Zip | 75048-4980
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Country | US
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Telephone | 469-715-3489
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Fax | 469-715-3490
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Provider Business Mailing Address
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Address Line | 1461 VIA TOSCANA LN
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City | ROCKWALL
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State | TX
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Zip | 75032-7540
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Country | US
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Telephone | 617-816-3140
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHELLE MUSSON
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Credential | MD
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Telephone | 469-715-3489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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