Provider Demographics
NPI:1174596878
Name:MCMICHAEL, MELINDA COOK (MD)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:COOK
Last Name:MCMICHAEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7339
Mailing Address - Street 2:UT STATION
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78713-7339
Mailing Address - Country:US
Mailing Address - Phone:512-475-8415
Mailing Address - Fax:
Practice Address - Street 1:100 E DEAN KEETON ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712-1043
Practice Address - Country:US
Practice Address - Phone:512-475-8327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-12
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX G2074207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine