Individual
DR. JENNIFER LEIGH MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
A108594
CA
207W00000X
Ophthalmology Physician
Primary
P5106
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00308V
MEDICARE GROUP PTAN
TX
01
—
260392YKVC
MEDICARE PTAN
TX
01
—
3862578615
MYUTMB 3862578615-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
01/04/2013
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