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General NPI Number Information
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NPI Number | 1649988957
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Entity Type | Individual
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Provider Name | MELISSA NICOLE WHITE
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Gender | Female
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 10919 WEST RD APT 333
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City | HOUSTON
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State | TX
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Zip | 77064-7207
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Country | US
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Telephone | 713-478-5709
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Fax |
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Provider Business Mailing Address
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Address Line | 10919 WEST RD APT 333
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City | HOUSTON
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State | TX
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Zip | 77064-7207
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Country | US
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Telephone | 713-478-5709
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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 | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 400572
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License Number State | TX
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