Healthcare Provider Details

I. General information

NPI: 1972969897
Provider Name (Legal Business Name): MELANIE STANLEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2016
Last Update Date: 02/25/2020
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22001 SOUTHWEST FWY STE 100
RICHMOND TX
77469-7002
US

IV. Provider business mailing address

4911 SANDHILL DR
SUGAR LAND TX
77479-5320
US

V. Phone/Fax

Practice location:
  • Phone: 281-239-5037
  • Fax:
Mailing address:
  • Phone: 281-238-7870
  • Fax: 281-633-4985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP128504
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: