Provider Demographics
NPI:1174996557
Name:HARRELL, MICHEAL D
Entity type:Individual
Prefix:
First Name:MICHEAL
Middle Name:D
Last Name:HARRELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6411 SLATE STONE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-1223
Mailing Address - Country:US
Mailing Address - Phone:713-499-9292
Mailing Address - Fax:
Practice Address - Street 1:6411 SLATE STONE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-1223
Practice Address - Country:US
Practice Address - Phone:713-499-9292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)