MEDICARE: SAMUEL MELACK

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1629928866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL MELACK

Provider Business Mailing Address
First Line	:	9550 ELLA LEE LN APT 116
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-1233
Country	:	US
Telephone Number	:	281-236-6014
Fax Number	:

Provider Business Practice Location Address
First Line	:	9550 ELLA LEE LN APT 116
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-1233
Country	:	US
Telephone Number	:	281-236-6014
Fax Number	:

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

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/29/2026

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Directions to “ SAMUEL MELACK ” Practice Location

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