Provider Demographics
NPI:1083926430
Name:MELISSA H MISKELL DO
Entity Type:Organization
Organization Name:MELISSA H MISKELL DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:H
Authorized Official - Last Name:MISKELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:830-627-7979
Mailing Address - Street 1:598 N UNION AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4136
Mailing Address - Country:US
Mailing Address - Phone:830-627-7979
Mailing Address - Fax:830-626-3963
Practice Address - Street 1:598 N UNION AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4136
Practice Address - Country:US
Practice Address - Phone:830-627-7979
Practice Address - Fax:830-626-3963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00956EMedicare UPIN