Provider Demographics
NPI:1932492162
Name:CAMPBELL, MICHELLE CROW (RDN, LD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CROW
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-2519
Mailing Address - Country:US
Mailing Address - Phone:713-622-6422
Mailing Address - Fax:889-755-9738
Practice Address - Street 1:407 HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-2519
Practice Address - Country:US
Practice Address - Phone:713-622-6422
Practice Address - Fax:889-755-9738
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-20
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07574133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered