Provider Demographics
NPI:1821083213
Name:GARCIA, MELISSA OEHL (PA)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:OEHL
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21216 NORTHWEST FWY
Mailing Address - Street 2:SUITE 620
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-1439
Mailing Address - Country:US
Mailing Address - Phone:281-469-7704
Mailing Address - Fax:281-469-4066
Practice Address - Street 1:21216 NORTHWEST FWY
Practice Address - Street 2:SUITE 620
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1439
Practice Address - Country:US
Practice Address - Phone:281-469-7704
Practice Address - Fax:281-469-4066
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02907363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
8N9698OtherBLUE CROSS BLUE SHIELD
8N9698OtherBLUE CROSS BLUE SHIELD
8G1327Medicare PIN
00889NMedicare PIN