Provider Demographics
NPI:1871753657
Name:CAMPBELL, MICHELE RILEY (DO)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:RILEY
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MRS
Other - First Name:MICHELE
Other - Middle Name:LEE
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3503 PICKERING LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7057
Mailing Address - Country:US
Mailing Address - Phone:281-997-9638
Mailing Address - Fax:281-997-9638
Practice Address - Street 1:3503 PICKERING LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7057
Practice Address - Country:US
Practice Address - Phone:281-997-9638
Practice Address - Fax:281-997-9638
Is Sole Proprietor?:No
Enumeration Date:2008-06-15
Last Update Date:2008-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9189207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine