Provider Demographics
NPI:1699047241
Name:LINARES, MELISSA (NP)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:LINARES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 BRAZOS TRL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6780
Mailing Address - Country:US
Mailing Address - Phone:972-578-0611
Mailing Address - Fax:
Practice Address - Street 1:9528 WEBB CHAPEL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-4938
Practice Address - Country:US
Practice Address - Phone:214-357-7311
Practice Address - Fax:214-352-8150
Is Sole Proprietor?:No
Enumeration Date:2012-01-28
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP120615363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX528250YKQLMedicare PIN