Provider Demographics
NPI:1336605732
Name:MELENDEZ, SAMMY CALEB (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:SAMMY
Middle Name:CALEB
Last Name:MELENDEZ
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7531 LEAFTEX DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-2613
Mailing Address - Country:US
Mailing Address - Phone:832-588-1010
Mailing Address - Fax:
Practice Address - Street 1:7531 LEAFTEX DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-2613
Practice Address - Country:US
Practice Address - Phone:832-588-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily