MEDICARE: MELISSA LAZARO PASCUAL

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	122300000X	Dentist	38813	TX

General Provider Information

NPI Number	:	1437899044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA LAZARO PASCUAL

Provider Business Mailing Address
First Line	:	50 SUGAR CREEK CENTER BLVD STE 100
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3692
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 SUGAR CREEK CENTER BLVD STE 100
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3692
Country	:	US
Telephone Number	:	281-494-2477
Fax Number	:

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

Provider Enumeration Date	:	03/31/2022
Last Update Date	:	03/05/2026

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