Individual
MELANIE P WICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
706 TURTLE CREEK DR, TYLER, TX 75701-1833
(903) 595-3942
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L7253
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159400401
—
TX
05
—
159400404
—
TX
05
—
159400405
—
TX
01
—
75-2616977-027
TRICARE
TX
Enumeration date
02/23/2006
Last updated
09/25/2017
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