Provider Demographics
NPI:1982829719
Name:WILKES REQUENEZ, MELISSA ERIN (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ERIN
Last Name:WILKES REQUENEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ERIN
Other - Last Name:WILKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9722 GASTON RD STE 150-277
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7941
Mailing Address - Country:US
Mailing Address - Phone:713-249-9411
Mailing Address - Fax:
Practice Address - Street 1:460 PARK GROVE DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1571
Practice Address - Country:US
Practice Address - Phone:413-862-2563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP24002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry