Individual
L. MICHELLE BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1401 W PULASKI ST, FORT WORTH, TX 76104-2717
(682) 885-8012
(682) 885-8014
Mailing address
PO BOX 99213, FORT WORTH, TX 76199-0213
(682) 885-1860
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101252892
VA
208000000X
Pediatrics Physician
32065
CO
208000000X
Pediatrics Physician
Primary
H6062
TX
Other
Enumeration date
02/01/2006
Last updated
01/26/2022
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