Provider Demographics
NPI:1467640920
Name:MELANIE O CHRISTINA MD PA
Entity Type:Organization
Organization Name:MELANIE O CHRISTINA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:CHRISTINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-263-0585
Mailing Address - Street 1:8335 WALNUT HILL LN STE 215
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4268
Mailing Address - Country:US
Mailing Address - Phone:214-758-7480
Mailing Address - Fax:147-587-4812
Practice Address - Street 1:8335 WALNUT HILL LN STE 215
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4268
Practice Address - Country:US
Practice Address - Phone:214-758-7480
Practice Address - Fax:214-758-7481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3766207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00475ZOtherMEDICARE GROUP #