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NPI Code Detail

MEDICARE: MARK ALAN MELISH M.D.

MEDICARE: MARK ALAN MELISH 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
1207L00000XAnesthesiology PhysicianG8278TX

General Provider Information

NPI Number : 1972638948
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK ALAN MELISH M.D.
Provider Business Mailing Address
First Line : PO BOX 29384
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-0384
Country : US
Telephone Number : 210-227-5168
Fax Number : 210-224-6945
Provider Business Practice Location Address
First Line : 621 N ALAMO ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78215-1836
Country : US
Telephone Number : 210-227-5223
Fax Number : 210-224-6945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 07/09/2007

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