Michael Lee Russell Sr., PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

38306 Issued in TX

Practice address

2525 North Loop West
Suite 400
Houston, TX 77008

Phone

(832) 394-1440

Fax

(832) 394-1448

NPI assigned

Feb 13, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Michael Russell, MD

  • Anesthesiology Physician
  • Elkins, WV
  • NPI 1962532051

  I20140226000454

  Same enrollment

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1255304887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 OTTER POND PLACE",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773814011",
            "telephone_number": "254-294-5605",
            "fax_number": "757-788-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NORTH LOOP WEST",
            "address_2": "SUITE 400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77008",
            "telephone_number": "832-394-1440",
            "fax_number": "832-394-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WA",
            "license": "PY00002256",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "38306",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002256",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kionte Russell, DPT
• Matasha L Russell, M.D.
• Melissa Lee Russell, ATC, LAT
• Melodi Russell, LPC, NCC
• Melvin David Russell, D.O.
• Michele Johnson Russell, MS LPC
• Morgan Christine Russell, PA-C
• Olivia Russell, MD
• Randi R Russell, NP
• Sammy Russell, MD

• Clinical Psychologist in Houston, TX
• Providers in Houston, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.