Individual
MRS. MICHELLE LYNN STORANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M0579
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265475891
GROUP NPI
TX
05
—
169952201
—
TX
01
—
173321401
MEDICAID-GOUP TPI
TX
01
—
173321402
MEDICAID-GROUP EPSDT
TX
Enumeration date
06/09/2006
Last updated
03/09/2012
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