Provider Demographics
NPI:1457576910
Name:BAY OAKS ORTHOPAEDICS & SPORTS MEDICINE, P.A.
Entity type:Organization
Organization Name:BAY OAKS ORTHOPAEDICS & SPORTS MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:MELILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-286-3500
Mailing Address - Street 1:1051 PINELOCH DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2742
Mailing Address - Country:US
Mailing Address - Phone:281-286-3500
Mailing Address - Fax:281-286-3553
Practice Address - Street 1:1051 PINELOCH DR
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-2742
Practice Address - Country:US
Practice Address - Phone:281-286-3500
Practice Address - Fax:281-286-3553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8057174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6411530001Medicare NSC
TXG11596Medicare UPIN
TX00492JMedicare PIN