Healthcare Provider Details

I. General information

NPI: 1528126935
Provider Name (Legal Business Name): MELINDA J HISCOCK MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 10/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3023 PERRYTON PKWY STE 202
PAMPA TX
79065-2821
US

IV. Provider business mailing address

3023 PERRYTON PKWY STE 202
PAMPA TX
79065-2821
US

V. Phone/Fax

Practice location:
  • Phone: 806-665-1500
  • Fax: 806-665-1502
Mailing address:
  • Phone: 806-665-1500
  • Fax: 806-665-1502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MELINDA HISCOCK
Title or Position: OWNER
Credential: MD
Phone: 806-665-1500