=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922922962
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRIANNA MARTINEZ MELENDEZ PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/04/2026
-----------------------------------------------------
Last Update Date | 08/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 506 TEXAS HIGHWAY 37 S
-----------------------------------------------------
City | MT VERNON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75457-3607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-537-8222
-----------------------------------------------------
Fax | 903-537-8223
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1311 LAMAR DR
-----------------------------------------------------
City | MOUNT PLEASANT
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75455-4111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-380-4042
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | PA20544
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------