Provider Demographics
NPI:1336886605
Name:PRESTIGE MEDICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:PRESTIGE MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:409-466-4690
Mailing Address - Street 1:1003 NEDERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-2832
Mailing Address - Country:US
Mailing Address - Phone:409-466-4690
Mailing Address - Fax:
Practice Address - Street 1:8595 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77640-2428
Practice Address - Country:US
Practice Address - Phone:409-344-4466
Practice Address - Fax:409-600-8141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier