MEDICARE: DR. CECILIA L. MELTON 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	10128	TX

General Provider Information

NPI Number	:	1538128525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CECILIA L. MELTON D.C.

Provider Business Mailing Address
First Line	:	24868 SHADY OAKS BLVD
Second Line	:
City	:	MONTGOMERY
State	:	TX
Zip	:	77316-3844
Country	:	US
Telephone Number	:	832-577-8189
Fax Number	:

Provider Business Practice Location Address
First Line	:	24868 SHADY OAKS BLVD
Second Line	:
City	:	MONTGOMERY
State	:	TX
Zip	:	77316-3844
Country	:	US
Telephone Number	:	832-577-8189
Fax Number	:

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

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	12/30/2022

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