Provider Demographics
NPI:1093489684
Name:CHE-SAMA, MELANIE A (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:A
Last Name:CHE-SAMA
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 1:919 RACELAND RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-3790
Mailing Address - Country:US
Mailing Address - Phone:352-219-9648
Mailing Address - Fax:
Practice Address - Street 1:11603 W COKER LOOP
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-3098
Practice Address - Country:US
Practice Address - Phone:210-494-1245
Practice Address - Fax:210-209-0289
Is Sole Proprietor?:No
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68948183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist