MEDICARE: DR. MELINDA ERIN VANVELDHUIZEN DC, FNP

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	10538	TX
2	363LF0000X	Family Nurse Practitioner	AP140494	TX

General Provider Information

NPI Number	:	1568599710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELINDA ERIN VANVELDHUIZEN DC, FNP

Provider Business Mailing Address
First Line	:	4001 MCEWEN RD STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5021
Country	:	US
Telephone Number	:	214-295-9671
Fax Number	:	972-432-5139

Provider Business Practice Location Address
First Line	:	4001 MCEWEN RD
Second Line	:	STE 100
City	:	DALLAS
State	:	TX
Zip	:	75244-5021
Country	:	US
Telephone Number	:	214-952-3933
Fax Number	:	972-432-5139

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	01/13/2020

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