Provider Demographics
NPI:1518679885
Name:TOON, MELANIE (LMT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:TOON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 N FM 3083 RD W STE 700
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-4569
Mailing Address - Country:US
Mailing Address - Phone:936-756-3747
Mailing Address - Fax:936-756-8906
Practice Address - Street 1:1140 N FM 3083 RD W STE 700
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-4569
Practice Address - Country:US
Practice Address - Phone:936-756-3747
Practice Address - Fax:936-756-8906
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT112126225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist