MEDICARE: MELISSA ANN STEPHENS D.C.

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
1	111N00000X	Chiropractor	DC 5057	TX

General Provider Information

NPI Number	:	1174631386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANN STEPHENS D.C.

Provider Business Mailing Address
First Line	:	1702 DUNLAVY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-1010
Country	:	US
Telephone Number	:	713-529-1262
Fax Number	:	713-529-3746

Provider Business Practice Location Address
First Line	:	1702 DUNLAVY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-1010
Country	:	US
Telephone Number	:	713-529-1262
Fax Number	:	713-529-3746

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	07/09/2007

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