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Individual

MRS. MELANIE LUCIDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
12890 HILLCREST RD, SUITE 201, DALLAS, TX 75230-1504
(972) 386-6310
(972) 404-9150
Mailing address
9413 TRAIL HILL DR, DALLAS, TX 75238-1437
(972) 386-6310
(972) 404-9150

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1044960
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
571156586
TAX ID
TX
Enumeration date
03/28/2007
Last updated
07/08/2007
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