Provider Demographics
NPI:1477678902
Name:MELVIN C ALDRIDGE JR D C P C
Entity Type:Organization
Organization Name:MELVIN C ALDRIDGE JR D C P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALDRIDGE
Authorized Official - Suffix:JR
Authorized Official - Credentials:D C
Authorized Official - Phone:281-991-7676
Mailing Address - Street 1:6733 FAIRMONT PKWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-4403
Mailing Address - Country:US
Mailing Address - Phone:281-991-7676
Mailing Address - Fax:281-991-7617
Practice Address - Street 1:6733 FAIRMONT PKWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4403
Practice Address - Country:US
Practice Address - Phone:281-991-7676
Practice Address - Fax:281-991-7617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172477OtherHIGHMARK BCBS PROV NO
TX4091344OtherAETNA PROVIDER NO
TX2855167002OtherCIGNA PROVIDER NO
TX601007Medicare ID - Type Unspecified
TX172477OtherHIGHMARK BCBS PROV NO