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Individual

EVAN MELROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6835 AUSTIN CENTER BLVD, AUSTIN, TX 78731-3166
(512) 346-6611
(512) 406-7321
Mailing address
4515 SETON CENTER PKWY, SUITE 215-CREDENTIALING, AUSTIN, TX 78759-5290
(512) 406-6216

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L8433
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
352735001
TX
05
362735002
TX
Enumeration date
10/17/2006
Last updated
02/18/2016
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