Provider Demographics
NPI:1215388301
Name:HAMILTON, MELISA SUEANN
Entity Type:Individual
Prefix:
First Name:MELISA
Middle Name:SUEANN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4606 CEDAR SPRINGS RD
Mailing Address - Street 2:APT 1925
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-1299
Mailing Address - Country:US
Mailing Address - Phone:646-771-6649
Mailing Address - Fax:
Practice Address - Street 1:4606 CEDAR SPRINGS RD
Practice Address - Street 2:APT 1925
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-1299
Practice Address - Country:US
Practice Address - Phone:646-771-6649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other