MEDICARE: DR. ANTHONY STEPHEN MELILLO M.D.

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	207X00000X	Orthopaedic Surgery Physician	J8057	TX

General Provider Information

NPI Number	:	1598754103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY STEPHEN MELILLO M.D.

Provider Business Mailing Address
First Line	:	1051 PINELOCH DR
Second Line	:	SUITE 100
City	:	HOUSTON
State	:	TX
Zip	:	77062-2742
Country	:	US
Telephone Number	:	281-286-3500
Fax Number	:	281-286-3553

Provider Business Practice Location Address
First Line	:	1051 PINELOCH DR
Second Line	:	SUITE 100
City	:	HOUSTON
State	:	TX
Zip	:	77062-2742
Country	:	US
Telephone Number	:	281-286-3500
Fax Number	:	281-286-3553

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

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	09/16/2010

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