Individual
DR. MICHELLE JEAN BROCK CARABALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7208
(214) 456-2857
(214) 456-5406
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 456-2857
(214) 456-5406
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
50011
CO
2080P0214X
Pediatric Pulmonology Physician
Primary
N6190
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19451334
—
CO
05
—
COA106588
—
CT
Enumeration date
03/31/2008
Last updated
09/16/2015
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