Provider Demographics
NPI:1639904717
Name:GOEL, MELANIE D (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:D
Last Name:GOEL
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1937
Mailing Address - Country:US
Mailing Address - Phone:210-779-5876
Mailing Address - Fax:
Practice Address - Street 1:7411 JOHN SMITH DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6041
Practice Address - Country:US
Practice Address - Phone:210-617-8240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX805581163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse