Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | K4400 | TX |
N | 207VG0400X | Gynecologist | K4400 | TX |
NPI | 1093749004 |
---|---|
Provider Name | Dr. Melissa Kay Crochet |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 28/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105836403 | (05) | TX |
8AD897 | BC/BS (01) | TX |
F88193 | (02) | TX |