Provider Demographics
NPI:1023022340
Name:TOMPKINS, MELISSA LASOLA (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:LASOLA
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 117506
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75011-7506
Mailing Address - Country:US
Mailing Address - Phone:972-241-4208
Mailing Address - Fax:972-241-7189
Practice Address - Street 1:4333 N JOSEY LN
Practice Address - Street 2:SUITE 207
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4629
Practice Address - Country:US
Practice Address - Phone:972-394-2971
Practice Address - Fax:972-492-1261
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ4287207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00275460OtherRAILROAD MEDICARE
TX8808J0OtherBLUE CROSS BLUE SHIELD
TX046333301Medicaid
TX8808J0OtherBLUE CROSS BLUE SHIELD
TXP00275460OtherRAILROAD MEDICARE