Provider Demographics
NPI:1912421801
Name:LOURDES E MELENDEZ PLLC
Entity Type:Organization
Organization Name:LOURDES E MELENDEZ PLLC
Other - Org Name:LOURDES E MELENDEZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:E
Authorized Official - Last Name:MELENDEZ-OETINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-987-5500
Mailing Address - Street 1:10757 N 74TH ST UNIT 1006
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6470
Mailing Address - Country:US
Mailing Address - Phone:623-210-5892
Mailing Address - Fax:
Practice Address - Street 1:270 E HUNT HWY STE 10
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-4963
Practice Address - Country:US
Practice Address - Phone:480-987-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty