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Individual

ALEXANDER MELINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3900 UNIVERSITY BLVD, TYLER, TX 75799-6600
(903) 566-7000
Mailing address
3700 MCDONALD RD APT 232, TYLER, TX 75701-6252
(682) 323-6916

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AMR832756822
BLUECROSS BLUESHIELF
TX
Enumeration date
09/18/2018
Last updated
09/22/2018
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