Provider Demographics
NPI:1720808454
Name:BALDWIN, MICHELLE ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:BALDWIN
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 1:16910 N WAYNE LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4605
Mailing Address - Country:US
Mailing Address - Phone:832-425-9004
Mailing Address - Fax:
Practice Address - Street 1:4702 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-3921
Practice Address - Country:US
Practice Address - Phone:281-485-5705
Practice Address - Fax:832-553-3284
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor