Provider Demographics
NPI:1962748160
Name:SHELTON, MELBRA LYNN (CERTIFIELD EDUCATOR)
Entity type:Individual
Prefix:
First Name:MELBRA
Middle Name:LYNN
Last Name:SHELTON
Suffix:
Gender:F
Credentials:CERTIFIELD EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6955 ALMEDA RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-2009
Mailing Address - Country:US
Mailing Address - Phone:800-505-2980
Mailing Address - Fax:800-398-4615
Practice Address - Street 1:6955 ALMEDA RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-2009
Practice Address - Country:US
Practice Address - Phone:800-505-2980
Practice Address - Fax:800-398-4615
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty