Provider Demographics
NPI:1437238649
Name:MCNEAL, MELANIE NICOLE (PT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:NICOLE
Last Name:MCNEAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:NICOLE
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:2660 AUGUSTA DR
Mailing Address - Street 2:APT F 211
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-5682
Mailing Address - Country:US
Mailing Address - Phone:832-524-9044
Mailing Address - Fax:
Practice Address - Street 1:2200 SOUTHWEST FWY
Practice Address - Street 2:STE 500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-4710
Practice Address - Country:US
Practice Address - Phone:713-526-6143
Practice Address - Fax:713-527-8215
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
TX1127132225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist