Individual
MELISSA IRENE LIVERMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6201 HARRY HINES BLVD, DALLAS, TX 75235-5202
(214) 633-4700
Mailing address
6201 HARRY HINES BLVD, DALLAS, TX 75235-5202
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA16399
TX
Other
Enumeration date
11/07/2022
Last updated
04/30/2026
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