Provider Demographics
NPI:1730417767
Name:GORDON, MELIA (CD(DONA))
Entity type:Individual
Prefix:
First Name:MELIA
Middle Name:
Last Name:GORDON
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15215 QUIET POND CT
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-4555
Mailing Address - Country:US
Mailing Address - Phone:512-419-8143
Mailing Address - Fax:
Practice Address - Street 1:15215 QUIET POND CT
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-4555
Practice Address - Country:US
Practice Address - Phone:512-419-8143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula