MEDICARE: DR. MELISSA LEE DEFOE 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	208M00000X	Hospitalist Physician	2015023842	MO
2	207RR0500X	Rheumatology Physician	R2570	TX

General Provider Information

NPI Number	:	1982043931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA LEE DEFOE MD

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-5347
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9900 N CENTRAL EXPY STE 550
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-0924
Country	:	US
Telephone Number	:	214-648-5295
Fax Number	:	214-648-6990

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

Provider Enumeration Date	:	06/21/2013
Last Update Date	:	09/28/2022

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