Healthcare Provider Details

I. General information

NPI: 1205455631
Provider Name (Legal Business Name): ANDREW THOMAS MELCHER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 HOUMA BLVD STE 325
METAIRIE LA
70006-4184
US

IV. Provider business mailing address

3800 HOUMA BLVD STE 325
METAIRIE LA
70006-4184
US

V. Phone/Fax

Practice location:
  • Phone: 504-952-8532
  • Fax: 504-456-5172
Mailing address:
  • Phone: 504-885-7337
  • Fax: 504-456-5172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number346895
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: