Mellard, Tandy Alice

Mellard, Tandy Alice is an individual health care provider with primary practice located at 4900 Mueller Blvd , Austin TX 78723-3079. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Mellard, Tandy Alice can be contacted via phone (512) 324-0197.

Contact Information

Primary practice address
4900 Mueller Blvd Austin TX 78723-3079
Phone: (512) 324-0197
Fax: (512) 324-0780
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 646493 Texas
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 646493 Texas

Profile Details

NPI number 1427138833
LBN Legal business name Mellard, Tandy Alice
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated Apr 8th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427138833 NPPES
Texas MEDICAID 176872303

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