Healthcare Provider Details

I. General information

NPI: 1730330176
Provider Name (Legal Business Name): MELISSA S THOMAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2008
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2358 MARONEAL ST
HOUSTON TX
77030-3218
US

IV. Provider business mailing address

1908 THOMES AVE STE 12550
CHEYENNE WY
82001-3527
US

V. Phone/Fax

Practice location:
  • Phone: 303-776-5298
  • Fax:
Mailing address:
  • Phone: 303-776-5298
  • Fax: 303-682-2785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberN1183
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberN1183
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: