Individual
MELISSA A SOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 648-4751
(214) 648-7660
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 648-4751
(214) 648-7660
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME97461
FL
207L00000X
Anesthesiology Physician
Primary
Q1753
TX
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Q1753
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277740100
—
FL
01
—
7267902
AETNA GTBA
FL
01
—
92099
BCBS
FL
01
—
AC891Z
GTBA MEDICARE REASSIGN
FL
Enumeration date
03/26/2007
Last updated
10/09/2014
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