Provider Demographics
NPI:1124326566
Name:MCCAULEY, MELISSA (LM, CPM)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 38TH STREET
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413
Mailing Address - Country:US
Mailing Address - Phone:806-831-5057
Mailing Address - Fax:806-370-6535
Practice Address - Street 1:3609 38TH STREET
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413
Practice Address - Country:US
Practice Address - Phone:806-831-5057
Practice Address - Fax:806-370-6535
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99117176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife