Provider Demographics
NPI:1811992589
Name:MISKELL, MELISSA H (DO)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:H
Last Name:MISKELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 N UNION AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4136
Mailing Address - Country:US
Mailing Address - Phone:830-627-7979
Mailing Address - Fax:830-626-3963
Practice Address - Street 1:598 N UNION AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4136
Practice Address - Country:US
Practice Address - Phone:830-627-7979
Practice Address - Fax:830-626-3963
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2754207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG72057Medicare UPIN