Provider Demographics
NPI:1730177304
Name:MULLER, MELISSA (OD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:MULLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6422 E SPEEDWAY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1151
Mailing Address - Country:US
Mailing Address - Phone:520-327-3487
Mailing Address - Fax:520-327-3488
Practice Address - Street 1:395 N SILVERBELL RD STE 255
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2714
Practice Address - Country:US
Practice Address - Phone:520-327-3487
Practice Address - Fax:520-327-3488
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ941152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ162075Medicare PIN
AZZ25055Medicare PIN
AZU73142Medicare UPIN
AZZ162695Medicare PIN