Provider Demographics
NPI:1013122399
Name:CORDELL, MELISSA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:CORDELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4718 WARING ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-6220
Mailing Address - Country:US
Mailing Address - Phone:713-840-7670
Mailing Address - Fax:713-529-8350
Practice Address - Street 1:4340 WESTHEIMER RD STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-4888
Practice Address - Country:US
Practice Address - Phone:713-955-6560
Practice Address - Fax:832-649-4933
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP112531363LF0000X
TX626005363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX626005OtherTX LICENSE FNP