Provider Demographics
NPI:1952310724
Name:MELTON, KARIN INGRID (PHD)
Entity Type:Individual
Prefix:DR
First Name:KARIN
Middle Name:INGRID
Last Name:MELTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5709 5TH ST
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-1917
Mailing Address - Country:US
Mailing Address - Phone:281-392-5666
Mailing Address - Fax:281-391-5050
Practice Address - Street 1:5709 5TH ST
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-1917
Practice Address - Country:US
Practice Address - Phone:281-392-5666
Practice Address - Fax:281-391-5050
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-2690103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000QH942Medicaid
TX5380405OtherAETNA INSURANCE
TX035466401Medicaid
TX109825175OtherUNITED BEHAVIORAL HEALTH
TX000QH942Medicaid