Individual
DR. MELODY RENE VANDER STRATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5145 N FM 620 RANCH ROAD, BLDG I, AUSTIN, TX 78732-1815
(512) 681-5900
(512) 681-5922
Mailing address
12221 N MOPAC EXPY, AUSTIN, TX 78758-2401
(512) 681-5900
(512) 681-5922
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M1393
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
334731201
—
TX
01
—
8BS530
BCBS
TX
01
—
8M7132
BCBS OF TEXAS INDIVIDUAL #
TX
01
—
P01539122
RRMC PTAN
TX
Enumeration date
02/06/2006
Last updated
12/29/2015
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