Provider Demographics
NPI:1356358782
Name:NOELL, MELISSA
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:NOELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:NOELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1432 UNDERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-7002
Mailing Address - Country:US
Mailing Address - Phone:940-566-3232
Mailing Address - Fax:940-382-1604
Practice Address - Street 1:1432 UNDERWOOD ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-7002
Practice Address - Country:US
Practice Address - Phone:940-566-3232
Practice Address - Fax:940-382-1604
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9471111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164119301Medicaid
TX8H5090OtherBLUE CROSS
TX2660664OtherCIGNA HMO
TXU94825Medicare UPIN
TX2660664OtherCIGNA HMO