Provider Demographics
NPI:1548218399
Name:MELCHER, LINETTE B (MD)
Entity Type:Individual
Prefix:MRS
First Name:LINETTE
Middle Name:B
Last Name:MELCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 HILL COUNTRY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6165
Mailing Address - Country:US
Mailing Address - Phone:830-257-3669
Mailing Address - Fax:830-895-1147
Practice Address - Street 1:712 HILL COUNTRY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6165
Practice Address - Country:US
Practice Address - Phone:830-257-3669
Practice Address - Fax:830-895-1147
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9524174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AJ129OtherBCBS
TX031481701Medicaid
TX031481701Medicaid
TXG76513Medicare UPIN
TX8F5384Medicare Oscar/Certification