Provider Demographics
NPI:1982043931
Name:DEFOE, MELISSA LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:LEE
Last Name:DEFOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9900 N CENTRAL EXPY STE 550
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0924
Practice Address - Country:US
Practice Address - Phone:214-648-5295
Practice Address - Fax:214-648-6990
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2015023842208M00000X
TXR2570207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist