Provider Demographics
NPI:1609945849
Name:WILLIAMS-TAURIAC, MELISSA A (OD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:WILLIAMS-TAURIAC
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6823 HILLWOOD LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-5032
Mailing Address - Country:US
Mailing Address - Phone:972-556-2929
Mailing Address - Fax:972-556-2057
Practice Address - Street 1:5910 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 148
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3806
Practice Address - Country:US
Practice Address - Phone:972-556-2929
Practice Address - Fax:972-556-2057
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5672T152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5672TOtherSTATE LICENSE NUMBER
TX5672TOtherSTATE LICENSE NUMBER
TX83172EMedicare ID - Type Unspecified