MEDICARE: DR. MICHELLE LEE CISNEROS OD

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	152W00000X	Optometrist	06583TG	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

General Provider Information

NPI Number	:	1285609842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE LEE CISNEROS OD

Provider Business Mailing Address
First Line	:	2370 N EXPRESSWAY STE 1532B
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78521-1106
Country	:	US
Telephone Number	:	956-888-7773
Fax Number	:	956-338-1753

Provider Business Practice Location Address
First Line	:	2370 N EXPRESSWAY STE 1532B
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78521-1106
Country	:	US
Telephone Number	:	956-888-7773
Fax Number	:	956-338-1532

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

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	02/18/2026

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