Provider Demographics
NPI:1285916098
Name:CHANDLER, MELISSA HOLLINGSWORTH (PHARMD, MHA)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:HOLLINGSWORTH
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:PHARMD, MHA
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:HOLLINSGWORTH
Other - Last Name:DISEDARE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1806 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-6704
Mailing Address - Country:US
Mailing Address - Phone:318-372-9786
Mailing Address - Fax:
Practice Address - Street 1:22730 PROFESSIONAL DR STE 110
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-6004
Practice Address - Country:US
Practice Address - Phone:281-312-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019493183500000X
TX68206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist