Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | G3322 | TX |
NPI | 1013003292 |
---|---|
Provider Name | Melanie Ehni Mouzoon |
First Address | Pearland, TX 77584-7298 |
Second Address | Houston, TX 77030-2312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 14/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101171006 | (05) | TX |
101171007 | (05) | TX |