MEDICARE: MS. MELANIE E ST. LAURENT NP

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	363L00000X	Nurse Practitioner	672585	TX
2	363LF0000X	Family Nurse Practitioner	672585	TX
3	363LF0000X	Family Nurse Practitioner	AP115439	TX

General Provider Information

NPI Number	:	1225184781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELANIE E ST. LAURENT NP

Provider Business Mailing Address
First Line	:	11511 KATY FWY
Second Line	:	SUITE 535
City	:	HOUSTON
State	:	TX
Zip	:	77079-1903
Country	:	US
Telephone Number	:	281-600-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	11511 KATY FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-1903
Country	:	US
Telephone Number	:	281-890-4285
Fax Number	:

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	07/31/2020

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