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Dr. Melody S. Martin
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NPI Number Detailed Information
Provider Information:
Name: | Dr. Melody S. Martin |
Gender: | F |
Provider License Number If Given: | 50259 |
NPI Information:
NPI: | 1689677734 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 5/23/2005 |
Last Update Date: | 5/17/2013 |
Provider Business Mailing Address:
Address: | 4720 W WACO DR Waco, TX 76710 |
Phone Number: | 2547329741 |
Fax Number: | 2547329745 |
Provider Business Practice Location Address:
Address: | 4720 W WACO DR Waco, TX 76710 |
Phone Number: | 2547329741 |
Fax Number: | 2547329745 |
Provider Taxonomy:
Primary: | 231H00000X |
Secondary (if any): | 235Z00000X |
State: | TX |