Provider Demographics
NPI:1699135947
Name:ALBA, MELINDA
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:ALBA
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 1:15315 SOUTHWEST FWY STE 175
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3832
Mailing Address - Country:US
Mailing Address - Phone:832-628-2169
Mailing Address - Fax:
Practice Address - Street 1:15315 SOUTHWEST FWY STE 175
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3832
Practice Address - Country:US
Practice Address - Phone:832-628-2169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier