Basic Information
| Provider Information | |||||||||
| NPI: | 1518281427 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HITE | ||||||||
| FirstName: | MELINDA | ||||||||
| MiddleName: | RAE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DPT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CLARK | ||||||||
| OtherFirstName: | MELINDA | ||||||||
| OtherMiddleName: | RAE | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4401 LONG PRAIRIE RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | FLOWER MOUND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750281794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9726911331 | ||||||||
| FaxNumber: | 9726911731 | ||||||||
| Practice Location | |||||||||
| Address1: | 4401 LONG PRAIRIE RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | FLOWER MOUND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750281794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9726911331 | ||||||||
| FaxNumber: | 9726911731 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2010 | ||||||||
| LastUpdateDate: | 03/22/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1189300 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.