MEDICARE: MELISSA MESA

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	374U00000X	Home Health Aide

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0482	OTHER	TX	HOME HEALTH CARE FOR PEOPLE WITH DISABILITIES

General Provider Information

NPI Number	:	1215550884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA MESA

Provider Business Mailing Address
First Line	:	7238 FAUNA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77061-3903
Country	:	US
Telephone Number	:	832-964-6140
Fax Number	:

Provider Business Practice Location Address
First Line	:	7238 FAUNA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77061-3903
Country	:	US
Telephone Number	:	832-964-6140
Fax Number	:

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

Provider Enumeration Date	:	05/18/2020
Last Update Date	:	05/23/2020

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Directions to “ MELISSA MESA ” Practice Location

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