Individual
MS. TANDY ALICE MELLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
4900 MUELLER BLVD, AUSTIN, TX 78723-3079
(512) 324-0197
(512) 324-0780
Mailing address
1301 BARBARA JORDAN BLVD, SUITE #200, AUSTIN, TX 78723-3077
(512) 628-1932
(512) 628-1801
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
646493
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
646493
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176872303
—
TX
Enumeration date
10/17/2006
Last updated
04/08/2013
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