Individual
MELISSA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
621 CAMDEN ST, STE 202, SAN ANTONIO, TX 78215-1612
(210) 253-3422
(210) 227-9833
Mailing address
PO BOX 35629, DALLAS, TX 75235-0629
(214) 424-2200
(214) 231-2159
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61639634
WA
363LF0000X
Family Nurse Practitioner
AP126071
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
359783301
—
TX
01
—
8953NT
BLUE CROSS BLUE SHIELD
TX
01
—
P01733200
RAILROAD MEDICARE
TX
Enumeration date
07/24/2014
Last updated
10/06/2025
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