Provider Demographics
NPI:1386087492
Name:IGLESIAS, MICHELLE (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:IGLESIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9895 ALAMEDA AVE
Mailing Address - Street 2:SUITE118
Mailing Address - City:SOCORRO
Mailing Address - State:TX
Mailing Address - Zip Code:79927-2833
Mailing Address - Country:US
Mailing Address - Phone:915-440-0099
Mailing Address - Fax:915-532-8006
Practice Address - Street 1:9895 ALAMEDA AVE
Practice Address - Street 2:SUITE118
Practice Address - City:SOCORRO
Practice Address - State:TX
Practice Address - Zip Code:79927-2833
Practice Address - Country:US
Practice Address - Phone:915-440-0099
Practice Address - Fax:915-532-8006
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR0251207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty