Provider Demographics
NPI:1568531739
Name:CHIANG, MELISSA P (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:P
Last Name:CHIANG
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 1:5061 FM 2920
Mailing Address - Street 2:
Mailing Address - City:SPTING
Mailing Address - State:TX
Mailing Address - Zip Code:77388
Mailing Address - Country:US
Mailing Address - Phone:281-829-8288
Mailing Address - Fax:281-404-9336
Practice Address - Street 1:5061 FM 2920
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388
Practice Address - Country:US
Practice Address - Phone:281-829-8288
Practice Address - Fax:281-404-9336
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2439207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WII72937Medicare UPIN
TXTXB131428Medicare PIN
WI34766900Medicaid
WI68635-0360Medicare ID - Type Unspecified
WIP00449570OtherRR MEDICARE
WI73500-0419Medicare ID - Type Unspecified
WI46236-0068Medicare PIN