Provider Demographics
NPI:1811339740
Name:LEUNG, MELANIE (OD)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:LEUNG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:9701 N SAM HOUSTON PKWY E STE 100
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4636
Mailing Address - Country:US
Mailing Address - Phone:281-360-2021
Mailing Address - Fax:
Practice Address - Street 1:9701 N SAM HOUSTON PKWY E STE 100
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4636
Practice Address - Country:US
Practice Address - Phone:281-360-2021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2015-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8219-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist