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Individual

CHARLI ATHENA MELLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
479 WESTPARK WAY, EULESS, TX 76040-3957
(817) 358-5500
(817) 358-5511
Mailing address
NORTHEAST TARRANT INTERNAL MEDICINE ASSOCIATES, LLP, 479 WESTPARK WAY, EULESS, TX 76040
(817) 358-5500
(817) 358-5511

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125070689
IL
207R00000X
Internal Medicine Physician
Primary
S9939
TX
208M00000X
Hospitalist Physician
73958-20
WI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/29/2017
Last updated
06/30/2023
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