Healthcare Provider Details

I. General information

NPI: 1578511549
Provider Name (Legal Business Name): MELISSA BILLINGS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2699 86TH ST
URBANDALE IA
50322-4309
US

IV. Provider business mailing address

2699 86TH ST
URBANDALE IA
50322-4309
US

V. Phone/Fax

Practice location:
  • Phone: 515-270-2490
  • Fax: 515-270-2494
Mailing address:
  • Phone: 515-270-2490
  • Fax: 515-270-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number02196
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number02196
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: