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General NPI Number Information
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NPI Number | 1891933065
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Entity Type | Individual
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Provider Name | MELODY MCCULLOUGH PTA
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Gender | Female
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Dates
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Enumeration Date | 01/27/2009
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Last Update Date | 04/25/2026
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Provider Practice Location Address
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Address Line | 23819 NORTHWOOD TERRACE LN
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City | KATY
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State | TX
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Zip | 77493-7136
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Country | US
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Telephone | 281-974-0383
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Fax |
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Provider Business Mailing Address
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Address Line | 19406 BRIARSEDGE CT
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City | KATY
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State | TX
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Zip | 77449-7506
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Country | US
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Telephone | 281-579-2206
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2064420
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | CP054272A
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License Number State | NH
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