MEDICARE: MELANIE MEGAN DOUGLASS

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	133V00000X	Registered Dietitian		TX

General Provider Information

NPI Number	:	1720947237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE MEGAN DOUGLASS

Provider Business Mailing Address
First Line	:	6061 VILLAGE BEND DR APT 507
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-3510
Country	:	US
Telephone Number	:	806-341-1967
Fax Number	:

Provider Business Practice Location Address
First Line	:	6061 VILLAGE BEND DR APT 507
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-3510
Country	:	US
Telephone Number	:	806-341-1967
Fax Number	:

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

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ MELANIE MEGAN DOUGLASS ” Practice Location

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