Healthcare Provider Details

I. General information

NPI: 1083452213
Provider Name (Legal Business Name): CAROLINA MICHELLE MEJIA ALANIZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2024
Last Update Date: 07/20/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 FANNIN ST
HOUSTON TX
77030-2703
US

IV. Provider business mailing address

6550 FANNIN ST # SM1661
HOUSTON TX
77030-2717
US

V. Phone/Fax

Practice location:
  • Phone: 713-441-6722
  • Fax:
Mailing address:
  • Phone: 713-363-9604
  • Fax: 713-791-5126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: