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NPI Code Detail

MEDICARE: MRS. MELANIE ROSE QUINN PA-C

MEDICARE:  MRS. MELANIE ROSE QUINN  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA-00533OTHERTXPA-TSBME LIC #

General Provider Information

NPI Number : 1033480835
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELANIE ROSE QUINN PA-C
Provider Business Mailing Address
First Line : 3929 ROYAL PALMS CT
Second Line :
City : DALLAS
State : TX
Zip : 75244-7261
Country : US
Telephone Number : 214-315-3073
Fax Number :
Provider Business Practice Location Address
First Line : 3929 ROYAL PALMS COURT
Second Line :
City : DALLAS
State : TX
Zip : 75244
Country : US
Telephone Number : 214-315-3073
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2012
Last Update Date : 03/01/2016

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Directions to “ MRS. MELANIE ROSE QUINN PA-C” Practice Location

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