Individual
MELISSA A MACIBORSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
151 EXCHANGE BLVD, #500, HUTTO, TX 78634-5381
(512) 846-1244
(512) 846-1963
Mailing address
PO BOX 26726, AUSTIN, TX 78755-0726
(512) 407-8686
(512) 421-4489
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
BP1-0023816
TX
208000000X
Pediatrics Physician
Primary
N0237
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195862101
—
TX
05
—
195862102
—
TX
01
—
3805159070
MYUTMB 3805159070-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
01/07/2011
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