Provider Demographics
NPI:1558667311
Name:KITAGAWA, MELANIE GWENDOLYN (MD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:GWENDOLYN
Last Name:KITAGAWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:GWENDOLYN
Other - Last Name:FEARING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6621 FANNIN ST
Mailing Address - Street 2:SUITE W6006 TEXAS CHILDRENS HOSPITAL CRITICAL CARE
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2303
Mailing Address - Country:US
Mailing Address - Phone:832-826-6230
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:SUITE W6006 TEXAS CHILDRENS HOSPITAL CRITICAL CARE
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2303
Practice Address - Country:US
Practice Address - Phone:832-826-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP60092080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine