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General NPI Number Information
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NPI Number | 1366675282
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Entity Type | Individual
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Provider Name | ELIZABETH MELINE
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Gender | Female
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 2715 W TRENTON RD
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City | EDINBURG
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State | TX
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Zip | 78539-3433
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Country | US
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Telephone | 956-316-2224
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Fax |
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Provider Business Mailing Address
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Address Line | 4614 SHOAL CREEK DR
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City | COLLEGE STATION
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State | TX
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Zip | 77845-4407
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Country | US
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Telephone | 979-229-7485
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1189691
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License Number State | TX
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