MEDICARE: MICHELLE B BRICKER M.D.

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	207L00000X	Anesthesiology Physician	H9818	TX

General Provider Information

NPI Number	:	1639108624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE B BRICKER M.D.

Provider Business Mailing Address
First Line	:	8524 HIGHWAY 6 N
Second Line	:	BOX 342
City	:	HOUSTON
State	:	TX
Zip	:	77095-2103
Country	:	US
Telephone Number	:	281-345-2743
Fax Number	:

Provider Business Practice Location Address
First Line	:	8524 HIGHWAY 6 N
Second Line	:	BOX 342
City	:	HOUSTON
State	:	TX
Zip	:	77095-2103
Country	:	US
Telephone Number	:	281-345-2743
Fax Number	:

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

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	07/08/2007

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