MEDICARE: MS. MELODY ANNE MALONE P.T.

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	174400000X	Specialist	124792	TX

General Provider Information

NPI Number	:	1346231206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELODY ANNE MALONE P.T.

Provider Business Mailing Address
First Line	:	4924 BRANDENBURG LN
Second Line	:
City	:	THE COLONY
State	:	TX
Zip	:	75056-2015
Country	:	US
Telephone Number	:	972-625-6283
Fax Number	:	972-625-9834

Provider Business Practice Location Address
First Line	:	4924 BRANDENBURG LN
Second Line	:
City	:	THE COLONY
State	:	TX
Zip	:	75056-2015
Country	:	US
Telephone Number	:	972-625-6283
Fax Number	:	972-625-9834

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	07/08/2007

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