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Individual
DR. MELVIN G CLEVELAND JR.
Active
Individual
DR. MELVIN G CLEVELAND JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2788TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1216335-01
—
TX
01
—
80648Q
BLUE CROSS BLUE SHIELD
TX
01
—
P00747362
MEDICARE RAILROAD
TX
Enumeration date
11/14/2005
Last updated
11/12/2009
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