MEDICARE: MELANIE SIMPSON LLC

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1578372769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MELANIE SIMPSON LLC

Provider Business Mailing Address
First Line	:	412 ROY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-7248
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	412 ROY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-7248
Country	:	US
Telephone Number	:	860-989-9028
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED DIETITIAN
Name	:	MELANIE SIMPSON
Credential	:	RD, LD
Telephone Number	:	860-989-9028

Provider Enumeration Date	:	01/02/2025
Last Update Date	:	01/02/2025

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