Provider Demographics
NPI:1689036386
Name:LYNN, MELODIE MINTER (DO)
Entity Type:Individual
Prefix:
First Name:MELODIE
Middle Name:MINTER
Last Name:LYNN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MELODIE
Other - Middle Name:MARIE
Other - Last Name:MINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1935 MEDICAL DISTRICT DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7701
Mailing Address - Country:US
Mailing Address - Phone:214-456-4078
Mailing Address - Fax:214-456-7758
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-4078
Practice Address - Fax:214-456-7758
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS14452080P0202X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics