MEDICARE: MELTON PSYCHIATRY PLLC

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1477230100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MELTON PSYCHIATRY PLLC

Provider Business Mailing Address
First Line	:	2211 NORFOLK ST STE 535
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-4164
Country	:	US
Telephone Number	:	832-930-1190
Fax Number	:

Provider Business Practice Location Address
First Line	:	2211 NORFOLK ST STE 535
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-4164
Country	:	US
Telephone Number	:	832-930-1190
Fax Number	:	713-554-2508

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	BENGI BIBER MELTON
Credential	:	MD
Telephone Number	:	832-334-1250

Provider Enumeration Date	:	07/04/2023
Last Update Date	:	05/29/2024

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