Provider Demographics
NPI:1740438738
Name:NIX, MELISSA SUE (DDS)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:SUE
Last Name:NIX
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:903 EAST LENNON DRIVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:EMORY
Mailing Address - State:TX
Mailing Address - Zip Code:75440-5229
Mailing Address - Country:US
Mailing Address - Phone:903-474-6010
Mailing Address - Fax:903-474-6011
Practice Address - Street 1:903 EAST LENNON DRIVE
Practice Address - Street 2:SUITE 108
Practice Address - City:EMORY
Practice Address - State:TX
Practice Address - Zip Code:75440-5229
Practice Address - Country:US
Practice Address - Phone:903-474-6010
Practice Address - Fax:903-474-6011
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX239641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice