MEDICARE: RICHARD JOSEPH MELLO NP

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	363LF0000X	Family Nurse Practitioner	1072932	TX

General Provider Information

NPI Number	:	1801539622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD JOSEPH MELLO NP

Provider Business Mailing Address
First Line	:	3701 ROY RICHARD DR
Second Line	:	SUITE 100
City	:	SCHERTZ
State	:	TX
Zip	:	78154-2711
Country	:	US
Telephone Number	:	210-945-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	3071 ROY RICHARD DR
Second Line	:	SUITE 100
City	:	SCHERTZ
State	:	TX
Zip	:	78154-2711
Country	:	US
Telephone Number	:	210-945-2121
Fax Number	:

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

Provider Enumeration Date	:	04/19/2022
Last Update Date	:	08/01/2022

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Directions to “ RICHARD JOSEPH MELLO NP” Practice Location

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