| |
4001 Mcewen Rd Ste 100, Dallas, TX 75244-5021 | |
(214) 295-9671 | |
(972) 432-5139 |
Full Name | |
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Type | Facility |
Speciality | Nurse Practitioner - Family |
Location | 4001 Mcewen Rd Ste 100, Dallas, Texas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083801211 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Provider Name | Melinda E Vanveldhuizen |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568599710 PECOS PAC ID: 6406927789 Enrollment ID: I20080618000571 |
Mailing Address | Practice Location Address |
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4001 Mcewen Rd Ste 100, Dallas, TX 75244-5021 Ph: (214) 295-9671 | 4001 Mcewen Rd Ste 100, Dallas, TX 75244-5021 Ph: (214) 295-9671 |