Provider Demographics
NPI:1104801679
Name:UHRICH, M. MELINDA (MD)
Entity type:Individual
Prefix:
First Name:M.
Middle Name:MELINDA
Last Name:UHRICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3232 BROADWAY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1728
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3232 BROADWAY BLVD STE A
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1728
Practice Address - Country:US
Practice Address - Phone:972-587-7126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9545208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139590701Medicaid
TX139590706Medicaid
TX139590714Medicaid
TX139590715Medicaid
TX139590702Medicaid
TX139590705Medicaid
TX139590708Medicaid
TX139590707Medicaid
TX139590712Medicaid
TX139590704Medicaid
TX139590716Medicaid
TX139590709Medicaid
TX139590715Medicaid
TX139590716Medicaid