Individual
ELIZABETH MELLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
19200 PRESTON RD STE 120, DALLAS, TX 75252-2450
(469) 200-2832
(469) 269-1074
Mailing address
19200 PRESTON RD STE 120, DALLAS, TX 75252-2450
(469) 200-2832
(469) 269-1074
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1291950
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1291950
TX BOARD OF PHYSICAL THERAPY
TX
Enumeration date
06/20/2017
Last updated
11/23/2021
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