Provider Demographics
NPI:1588397582
Name:DANHO, MELISA PORTUONDO
Entity type:Individual
Prefix:
First Name:MELISA
Middle Name:PORTUONDO
Last Name:DANHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25335 BUDDE RD APT 718
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2297
Mailing Address - Country:US
Mailing Address - Phone:713-548-7676
Mailing Address - Fax:
Practice Address - Street 1:25335 BUDDE RD APT 718
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2297
Practice Address - Country:US
Practice Address - Phone:713-548-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83423133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered