Provider Demographics
NPI:1588789887
Name:MELENDEZ, DEBORAH L (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:L
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7500 RIALTO BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8531
Mailing Address - Country:US
Mailing Address - Phone:737-200-2967
Mailing Address - Fax:281-781-2493
Practice Address - Street 1:7500 RIALTO BLVD STE 260
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8531
Practice Address - Country:US
Practice Address - Phone:737-200-2967
Practice Address - Fax:281-781-2493
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5376207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX383195YLPSOtherWELLMED PTAN
TX207891702Medicaid
TX8L19296OtherMEDICARE