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General NPI Number Information
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NPI Number | 1689175937
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Entity Type | Individual
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Provider Name | STEPHANIE MELGOZA
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Gender | Female
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Dates
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Enumeration Date | 02/22/2018
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Last Update Date | 02/05/2021
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Provider Practice Location Address
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Address Line | 14438 JONES MALTSBERGER RD APT 509
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City | SAN ANTONIO
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State | TX
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Zip | 78247-3747
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Country | US
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Telephone | 956-960-7386
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 460172
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City | SAN ANTONIO
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State | TX
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Zip | 78246-0172
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Country | US
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Telephone | 956-960-7386
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 36583
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License Number State | TX
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