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NPI Code Detail

MEDICARE: MELISSA LYNN INNISS

MEDICARE: MELISSA LYNN INNISS
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
1106S00000XBehavior TechnicianRBT-26-507427TX

General Provider Information

NPI Number : 1588503056
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA LYNN INNISS
Provider Business Mailing Address
First Line : 5180 WESTERN CENTER BLVD
Second Line :
City : HALTOM CITY
State : TX
Zip : 76137-2144
Country : US
Telephone Number : 682-888-5983
Fax Number : 682-390-3123
Provider Business Practice Location Address
First Line : 5180 WESTERN CENTER BLVD
Second Line :
City : HALTOM CITY
State : TX
Zip : 76137-2144
Country : US
Telephone Number : 682-888-5983
Fax Number : 682-390-3123
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2026
Last Update Date : 03/27/2026

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Directions to “ MELISSA LYNN INNISS ” Practice Location

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