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General NPI Number Information
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NPI Number | 1962160028
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Entity Type | Individual
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Provider Name | MELISSA IRENE PECHAL FNP
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Gender | Female
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 2320 W LOOP 340 STE 200A
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City | WACO
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State | TX
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Zip | 76711-2454
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Country | US
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Telephone | 254-218-5284
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Fax |
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Provider Business Mailing Address
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Address Line | 1112 N 13TH ST
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City | TEMPLE
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State | TX
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Zip | 76501-1951
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Country | US
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Telephone | 254-654-2212
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1060036
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License Number State | TX
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