Provider Demographics
NPI:1912227752
Name:EDWARD P. MELMED, M.D. P.A
Entity Type:Organization
Organization Name:EDWARD P. MELMED, M.D. P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:MELMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:972-566-7755
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:A210
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2505
Mailing Address - Country:US
Mailing Address - Phone:972-566-7755
Mailing Address - Fax:972-566-7979
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:A210
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-566-7755
Practice Address - Fax:972-566-7979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00634OtherMEDICARE PROVIDER NUMBER
TXB24848Medicare UPIN