Individual
MICHELLE L DORTCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A-GNP
Contact information
Practice address
2660 GULF FWY S, LEAGUE CITY, TX 77573-6820
(940) 228-6583
Mailing address
PO BOX 650859, DEPT 710, DALLAS, TX 75265-0859
(409) 772-1221
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1073152
TX
363LA2200X
Adult Health Nurse Practitioner
1073152
TX
Other
Enumeration date
05/14/2022
Last updated
11/11/2022
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