MEDICARE: LUCERO MELISSA NUNEZ

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1982281309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCERO MELISSA NUNEZ

Provider Business Mailing Address
First Line	:	3801 N A W GRIMES BLVD
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-3021
Country	:	US
Telephone Number	:	956-508-1725
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 DEEP WOOD DR STE 104
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4935
Country	:	US
Telephone Number	:	512-910-3251
Fax Number	:

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

Provider Enumeration Date	:	03/24/2021
Last Update Date	:	07/16/2025

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