Provider Demographics
NPI:1740166925
Name:FREEZE, MICHELLE LEE (DC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LEE
Last Name:FREEZE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 CAMRYN LN
Mailing Address - Street 2:
Mailing Address - City:MABANK
Mailing Address - State:TX
Mailing Address - Zip Code:75147-1339
Mailing Address - Country:US
Mailing Address - Phone:903-309-3820
Mailing Address - Fax:
Practice Address - Street 1:5520 OLD BULLARD RD STE 114
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-4361
Practice Address - Country:US
Practice Address - Phone:903-309-3820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor