Provider Demographics
NPI:1326643388
Name:RELJAC, MELISSA PIERCE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:PIERCE
Last Name:RELJAC
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 S CROWLEY RD
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-3663
Mailing Address - Country:US
Mailing Address - Phone:817-297-2281
Mailing Address - Fax:817-297-3153
Practice Address - Street 1:825 S CROWLEY ROAD
Practice Address - Street 2:CVS PHARMACY
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-7603
Practice Address - Country:US
Practice Address - Phone:817-297-2281
Practice Address - Fax:817-297-3153
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist