Provider Demographics
NPI:1013521632
Name:TEJEDA, MELISSA (LVN)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:TEJEDA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 LIMESTONE FLT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4184
Mailing Address - Country:US
Mailing Address - Phone:210-412-1878
Mailing Address - Fax:
Practice Address - Street 1:530 LIMESTONE FLT
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4184
Practice Address - Country:US
Practice Address - Phone:210-412-1878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203977164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse