Provider Demographics
NPI:1902044381
Name:MELTON, LUES J (RN)
Entity Type:Individual
Prefix:
First Name:LUES
Middle Name:J
Last Name:MELTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LUES
Other - Middle Name:JEAN
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1430 COLLIER ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-2911
Mailing Address - Country:US
Mailing Address - Phone:512-445-7787
Mailing Address - Fax:512-440-4059
Practice Address - Street 1:1631 E 2ND ST STE D
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-4491
Practice Address - Country:US
Practice Address - Phone:512-804-3600
Practice Address - Fax:512-476-1469
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX249628163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse