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General NPI Number Information
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NPI Number | 1437254547
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Entity Type | Organization
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Legal Business Name | MARK A. MELISH, M.D., P.A.
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 06/16/2015
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Provider Practice Location Address
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Address Line | 621 N ALAMO ST
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1836
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Country | US
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Telephone | 210-227-5223
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Fax | 210-224-6945
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Provider Business Mailing Address
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Address Line | PO BOX 29384
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City | SAN ANTONIO
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State | TX
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Zip | 78229-0384
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Country | US
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Telephone | 210-227-5168
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Fax | 210-224-6945
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK A MELISH
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Credential | M.D.
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Telephone | 210-227-5223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G8278
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License Number State | TX
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