Provider Demographics
NPI:1881940690
Name:SANCHEZ, MELISSA LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MEDICAL PARK LN STE C
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4957
Mailing Address - Country:US
Mailing Address - Phone:936-291-3219
Mailing Address - Fax:939-291-7206
Practice Address - Street 1:125 MEDICAL PARK LN STE C
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4957
Practice Address - Country:US
Practice Address - Phone:936-291-3219
Practice Address - Fax:939-291-7206
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05616363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical