Individual
MR. MELVIN RICHARD GREEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2106 E SONTERRA BLVD STE 111, STUDIO 42, SAN ANTONIO, TX 78259-7608
(210) 313-6994
Mailing address
5931 LOST CREEK ST, SAN ANTONIO, TX 78247-1325
(210) 313-6994
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LMT 100005
TX
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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