Provider Demographics
NPI:1740623982
Name:THOMAS, MELODY K (BCABA, LABA, MT-BC)
Entity type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:K
Last Name:THOMAS
Suffix:
Gender:F
Credentials:BCABA, LABA, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7014 TAOS DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-4326
Mailing Address - Country:US
Mailing Address - Phone:361-815-7799
Mailing Address - Fax:
Practice Address - Street 1:7014 TAOS DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-4326
Practice Address - Country:US
Practice Address - Phone:361-815-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08368225A00000X
TX2096106E00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst