Provider Demographics
NPI:1568564656
Name:LANG, MELISSA LEE (APRN, WHNP)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:LEE
Last Name:LANG
Suffix:
Gender:F
Credentials:APRN, WHNP
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Mailing Address - Street 1:12200 PARK CENTRAL DR
Mailing Address - Street 2:#200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2100
Mailing Address - Country:US
Mailing Address - Phone:972-685-2740
Mailing Address - Fax:972-566-8461
Practice Address - Street 1:12200 PARK CENTRAL DR
Practice Address - Street 2:200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2100
Practice Address - Country:US
Practice Address - Phone:972-685-2740
Practice Address - Fax:972-566-8461
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX619749363LX0001X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP12584Medicare UPIN
TX8686J2Medicare ID - Type Unspecified