Provider Demographics
NPI:1609161934
Name:BAUGH, MELISSA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BAUGH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 I-30
Mailing Address - Street 2:CVS 10635
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189
Mailing Address - Country:US
Mailing Address - Phone:972-635-2470
Mailing Address - Fax:972-635-2456
Practice Address - Street 1:476 I-30
Practice Address - Street 2:CVS 10635
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189
Practice Address - Country:US
Practice Address - Phone:972-635-2470
Practice Address - Fax:972-635-2456
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist