Provider Demographics
NPI:1962493148
Name:MELTON, CHARLES M (DPM)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:M
Last Name:MELTON
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:5825 CALLAGHAN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1106
Mailing Address - Country:US
Mailing Address - Phone:210-227-8700
Mailing Address - Fax:210-348-9130
Practice Address - Street 1:2130 NE LOOP 410 STE 301
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-4662
Practice Address - Country:US
Practice Address - Phone:210-829-1880
Practice Address - Fax:210-822-6551
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2024-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1144213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX037162702Medicaid
TX8A4602OtherBCBS
TXU11935Medicare UPIN
TX8A4602OtherBCBS