Provider Demographics
NPI:1891183026
Name:ENGLE, MELISSA LESLIE (CRT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LESLIE
Last Name:ENGLE
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LESLIE
Other - Last Name:GROFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRT
Mailing Address - Street 1:7400 MERTON MINTER ST
Mailing Address - Street 2:ROOM E703
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4404
Mailing Address - Country:US
Mailing Address - Phone:210-617-5300
Mailing Address - Fax:210-617-5297
Practice Address - Street 1:7400 MERTON MINTER ST
Practice Address - Street 2:ROOM E703
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:210-617-5297
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74025227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified