Provider Demographics
NPI:1801834544
Name:MELNYK, ANTON M JR (MD,FACP)
Entity Type:Individual
Prefix:
First Name:ANTON
Middle Name:M
Last Name:MELNYK
Suffix:JR
Gender:M
Credentials:MD,FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:1100 N 19TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2344
Practice Address - Country:US
Practice Address - Phone:325-672-4368
Practice Address - Fax:325-672-3108
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8058207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046352301Medicaid
TX8R1503OtherBLUE CROSS OF TX
TX117946701Medicaid
TX117946702Medicaid
TX117946702Medicaid
TX830005269Medicare PIN
G13744Medicare UPIN
TX046352301Medicaid