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NPI Code Detail

MEDICARE: DR. MELISSA HENRY MD

MEDICARE: DR. MELISSA HENRY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianL0258TX
2207P00000XEmergency Medicine PhysicianL0258TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124023718
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MELISSA HENRY MD
Provider Business Mailing Address
First Line : 4515 MARSHA SHARP FWY
Second Line :
City : LUBBOCK
State : TX
Zip : 79407-2520
Country : US
Telephone Number : 806-744-7223
Fax Number : 806-740-3325
Provider Business Practice Location Address
First Line : 7509 MARSHA SHARP FWY
Second Line :
City : LUBBOCK
State : TX
Zip : 79407-8202
Country : US
Telephone Number : 806-744-7223
Fax Number : 806-740-3325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 12/01/2021

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Directions to “ DR. MELISSA HENRY MD” Practice Location

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