Provider Demographics
NPI:1194279943
Name:OSLUND-GOLDBERG, MELANIE (EPT)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:
Last Name:OSLUND-GOLDBERG
Suffix:
Gender:F
Credentials:EPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1577
Mailing Address - Street 2:#1
Mailing Address - City:WALLER
Mailing Address - State:TX
Mailing Address - Zip Code:77484-1577
Mailing Address - Country:US
Mailing Address - Phone:936-463-4991
Mailing Address - Fax:281-622-4381
Practice Address - Street 1:33518 HALEY RD
Practice Address - Street 2:#1
Practice Address - City:WALLER
Practice Address - State:TX
Practice Address - Zip Code:77484-5110
Practice Address - Country:US
Practice Address - Phone:936-463-4991
Practice Address - Fax:281-622-4381
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic