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General NPI Number Information
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NPI Number | 1427472125
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Entity Type | Individual
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Provider Name | MELANIE OLDHAM
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Gender | Female
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Dates
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Enumeration Date | 02/15/2014
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Last Update Date | 02/15/2014
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Provider Practice Location Address
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Address Line | 603 W 7TH ST
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City | FREEPORT
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State | TX
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Zip | 77541-5627
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Country | US
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Telephone | 979-481-2723
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Fax |
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Provider Business Mailing Address
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Address Line | 603 W 7TH ST
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City | FREEPORT
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State | TX
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Zip | 77541-5627
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Country | US
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Telephone |
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 1032373
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License Number State | TX
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