Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 036063571 | IL |
N | 2086S0120X | Pediatric Surgery | 42651 | TX |
Y | 2086S0120X | Pediatric Surgery | N9909 | TX |
NPI | 1508808833 |
---|---|
Provider Name | Janet Meller |
First Address | Amarillo, TX 79106-1708 |
Second Address | Amarillo, TX 79106-1786 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 05/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036063571 | (05) | IL |
200246040 A | (05) | OK |
202606401 | (05) | TX |
202606402 | MEDICAID - TTUHSC (01) | TX |
202606403 | (05) | TX |
202606404 | CSHCN- TTUHSC (01) | TX |
78358558 | (05) | NM |