Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 13295 | TX |
NPI | 1457808297 |
---|---|
Provider Name | Katherine Melot |
First Address | West Lake Hills, TX 78746-4440 |
Second Address | West Lake Hills, TX 78746-4440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2016 |
Last Update Date | 09/09/2016 |