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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 |
