Provider Demographics
NPI:1134480387
Name:MELNAR, MELISSA NICOLE (MED)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:NICOLE
Last Name:MELNAR
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 S FRY RD
Mailing Address - Street 2:# 465
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2256
Mailing Address - Country:US
Mailing Address - Phone:281-940-8515
Mailing Address - Fax:
Practice Address - Street 1:11999 KATY FWY
Practice Address - Street 2:590
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1611
Practice Address - Country:US
Practice Address - Phone:281-468-9280
Practice Address - Fax:281-597-9761
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67968101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional