=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407056294
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA MERCEDES MELENDEZ MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2007
-----------------------------------------------------
Last Update Date | 01/29/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1334 TERRY AVE
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98101-2747
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-682-2661
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 616 FM 1960 RD W STE 230
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77090-3000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-749-7428
-----------------------------------------------------
Fax | 281-724-3100
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2081H0002X
-----------------------------------------------------
Taxonomy Name | Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
-----------------------------------------------------
License Number | 2011028497
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | MD60509455
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------