Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 99117 | TX |
NPI | 1124326566 |
---|---|
Provider Name | Melissa Mccauley |
First Address | Lubbock, TX 79413 |
Second Address | Lubbock, TX 79413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2011 |
Last Update Date | 28/05/2014 |