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General NPI Number Information
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NPI Number | 1740291103
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Entity Type | Organization
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Legal Business Name | MELISSA K. CROCHET, MD, PA
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 411 N WASHINGTON AVE SUITE 2700
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City | DALLAS
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State | TX
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Zip | 75246-1713
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Country | US
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Telephone | 214-823-7900
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Fax | 214-239-4260
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Provider Business Mailing Address
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Address Line | 411 N WASHINGTON AVE SUITE 2700
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City | DALLAS
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State | TX
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Zip | 75246-1713
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Country | US
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Telephone | 214-823-7900
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Fax | 214-239-4260
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Authorized Official
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Title or Position | OWNER
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Name | DR. MELLISA KAY CROCHET
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Credential | MD
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Telephone | 214-823-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K4400
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License Number State | TX
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