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NPI Code Detail

MEDICARE: MELISSA O'TOOLE M.D.

MEDICARE: MELISSA O'TOOLE M.D.
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
12085R0202XDiagnostic Radiology PhysicianK3621TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00063463OTHERTXRAILROAD MEDICARE

General Provider Information

NPI Number : 1205838810
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA O'TOOLE M.D.
Provider Business Mailing Address
First Line : 714 FM 1960 RD W
Second Line :
City : HOUSTON
State : TX
Zip : 77090-3408
Country : US
Telephone Number : 281-880-6991
Fax Number :
Provider Business Practice Location Address
First Line : 17080 RED OAK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77090-2602
Country : US
Telephone Number : 281-880-6991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 03/19/2009

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Directions to “ MELISSA O'TOOLE M.D.” Practice Location

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