Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | J3766 | TX |
Y | 111NI0900X | Internist | J3766 | TX |
NPI | 1003805292 |
---|---|
Provider Name | Dr. Melanie Owen Christina |
First Address | Dallas, TX 75231-4268 |
Second Address | Dallas, TX 75231-4268 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 09/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F58694 | (02) | TX |