1164685970 NPI number — MRS. ASHLEY P. MELTON MCD CCC SLP

Table of content: MRS. ASHLEY P. MELTON MCD CCC SLP (NPI 1164685970)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164685970 NPI number — MRS. ASHLEY P. MELTON MCD CCC SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MELTON
Provider First Name:
ASHLEY
Provider Middle Name:
P.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MCD CCC SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164685970
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4840 W PANTHER CREEK DR
Provider Second Line Business Mailing Address:
SUITE 206
Provider Business Mailing Address City Name:
THE WOODLANDS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77381-3527
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-681-3020
Provider Business Mailing Address Fax Number:
281-298-9905

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4840 W PANTHER CREEK DR
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
THE WOODLANDS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77381-3527
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-681-3020
Provider Business Practice Location Address Fax Number:
281-298-9905
Provider Enumeration Date:
07/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  23786 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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