Provider Demographics
NPI:1861043192
Name:DECKER, MELISSA JANE (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:JANE
Last Name:DECKER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 N TEXANA ST
Mailing Address - Street 2:
Mailing Address - City:HALLETTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77964-2322
Mailing Address - Country:US
Mailing Address - Phone:361-798-5010
Mailing Address - Fax:361-798-1515
Practice Address - Street 1:304 N TEXANA ST
Practice Address - Street 2:
Practice Address - City:HALLETTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77964-2322
Practice Address - Country:US
Practice Address - Phone:361-798-5010
Practice Address - Fax:361-798-1515
Is Sole Proprietor?:No
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist