Provider Demographics
NPI:1871722686
Name:THORESON, MELISSA ANN (DO)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ANN
Last Name:THORESON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13501 METRIC BLVD UNIT 26
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-0220
Mailing Address - Country:US
Mailing Address - Phone:512-426-0115
Mailing Address - Fax:
Practice Address - Street 1:1101 S CAPITAL OF TEXAS HWY STE 100
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6445
Practice Address - Country:US
Practice Address - Phone:512-503-7399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP3221207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine