MEDICARE: MELISSA G WAMPLER MD

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	207VG0400X	Gynecology Physician	H9944	TX
2	207V00000X	Obstetrics & Gynecology Physician	H9944	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	81601X	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1932162864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA G WAMPLER MD

Provider Business Mailing Address
First Line	:	708 HILL COUNTRY DR STE 300A
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-6079
Country	:	US
Telephone Number	:	830-895-7755
Fax Number	:	830-895-7757

Provider Business Practice Location Address
First Line	:	1331 BANDERA HWY
Second Line	:	SUITE 2
City	:	KERRVILLE
State	:	TX
Zip	:	78028-9535
Country	:	US
Telephone Number	:	830-895-7755
Fax Number	:	830-895-7757

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	10/08/2020

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Directions to “ MELISSA G WAMPLER MD” Practice Location

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