Provider Demographics
NPI:1497956189
Name:SMALLEY, MELISSA ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ANN
Last Name:SMALLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 S TYLER ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79101-4240
Mailing Address - Country:US
Mailing Address - Phone:806-373-2812
Mailing Address - Fax:806-372-6550
Practice Address - Street 1:1501 S TYLER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79101-4240
Practice Address - Country:US
Practice Address - Phone:806-373-2812
Practice Address - Fax:806-372-6550
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42853174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist