Provider Demographics
NPI:1548347636
Name:FRYE, MELANIE JO (NP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:JO
Last Name:FRYE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:JO
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1907 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-4803
Mailing Address - Country:US
Mailing Address - Phone:281-990-1696
Mailing Address - Fax:
Practice Address - Street 1:1907 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-4803
Practice Address - Country:US
Practice Address - Phone:281-990-1696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP113698363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
8J3511Medicare PIN
Q77822Medicare UPIN