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NPI Code Detail

MEDICARE: MELANIE MOISES DO

MEDICARE:   MELANIE  MOISES  DO
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
1390200000XStudent in an Organized Health Care Education/Training ProgramBP10091326TX
2171000000XMilitary Health Care ProviderOS19367FL

General Provider Information

NPI Number : 1790312148
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE MOISES DO
Provider Business Mailing Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78234-4504
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 210-916-4854
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2020
Last Update Date : 06/24/2026

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Directions to “ MELANIE MOISES DO” Practice Location

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