Provider Demographics
NPI:1043756281
Name:WANEK, MELISSA HINOJOSA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:HINOJOSA
Last Name:WANEK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 RAYADO CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4084
Mailing Address - Country:US
Mailing Address - Phone:956-369-5286
Mailing Address - Fax:
Practice Address - Street 1:3033 S PORT AVE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-2040
Practice Address - Country:US
Practice Address - Phone:361-883-0875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56563183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist