Provider Demographics
NPI:1386744688
Name:CROSBY, MELISSA A (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:CROSBY
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 1:16605 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3501
Mailing Address - Country:US
Mailing Address - Phone:832-939-8500
Mailing Address - Fax:832-939-9909
Practice Address - Street 1:16605 SOUTHWEST FWY
Practice Address - Street 2:SUITE 300
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3501
Practice Address - Country:US
Practice Address - Phone:832-939-8500
Practice Address - Fax:832-939-9909
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1612208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174542401Medicaid
TX174542401Medicaid
TX405321YRW2Medicare PIN
I35151Medicare UPIN