MEDICARE: MR. ALEXANDER MARTIN MELENDEZ MORENO MD

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
1	207W00000X	Ophthalmology Physician	W4546	TX
2	390200000X	Student in an Organized Health Care Education/Training Program	37474	PR

General Provider Information

NPI Number	:	1114567476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALEXANDER MARTIN MELENDEZ MORENO MD

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-5347
Country	:	US
Telephone Number	:	214-645-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	5303 HARRY HINES BLVD FL 6
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-7208
Country	:	US
Telephone Number	:	214-645-2020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2020
Last Update Date	:	05/10/2026

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