Provider Demographics
NPI:1861630352
Name:WHITMAN, MELANIE BRUCE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:BRUCE
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:LYNN
Other - Last Name:BRUCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1810 SAND CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7769
Mailing Address - Country:US
Mailing Address - Phone:979-255-3547
Mailing Address - Fax:
Practice Address - Street 1:1810 SAND CREEK RD
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7769
Practice Address - Country:US
Practice Address - Phone:979-255-3547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1186973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1186973OtherLICENSE NUMBER