MEDICARE: DR. MELISSA MARIE STROUD 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	208000000X	Pediatrics Physician	M5943	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8CZ775	OTHER	TX	WCCA BCBSTX
3	8AH780	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1841405446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA MARIE STROUD M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2078
Second Line	:
City	:	DECATUR
State	:	TX
Zip	:	76234-6156
Country	:	US
Telephone Number	:	940-626-2718
Fax Number	:	940-626-1782

Provider Business Practice Location Address
First Line	:	609 MEDICAL CENTER DR STE 2218
Second Line	:
City	:	DECATUR
State	:	TX
Zip	:	76234-3836
Country	:	US
Telephone Number	:	940-626-2718
Fax Number	:	940-626-1782

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

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	04/26/2019

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