Healthcare Provider Details

I. General information

NPI: 1124301130
Provider Name (Legal Business Name): MELISSA RHEA BATES LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2011
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24906 CACTUS SAGE TRL
KATY TX
77494-3038
US

IV. Provider business mailing address

24906 CACTUS SAGE TRL
KATY TX
77494-3038
US

V. Phone/Fax

Practice location:
  • Phone: 832-419-9217
  • Fax:
Mailing address:
  • Phone: 832-419-9217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: