Individual provider Active NPI

Melissa Tieu, PHARMD

  • Pharmacist
  • Victoria, TX
National Provider Identifier
1093114142
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
018498 Issued in LA
Practice address
6404 Nursery Drive, Suite 101
Victoria, TX 77904
Phone
(361) 894-6835
Fax
(361) 894-6836
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 018498 LA Primary

Addresses

Primary practice location

6404 Nursery Drive, Suite 101
Victoria, TX 77904

Mailing address

6404 Nursery Drive, Suite 101
Victoria, TX 77904
Phone (361) 894-6835

Other names 1

  • Ms. Melissa Pham Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
018498LAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springwood Pharmacy, LLC CurrentSince Nov 24, 2024 Accepting new patients

Locations

6404 Nursery Dr
Ste 101
Victoria, TX 77904
Phone (361) 894-6835

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1093114142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 NURSERY DRIVE, SUITE 101",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "77904",
            "telephone_number": "361-894-6835",
            "fax_number": "361-894-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 NURSERY DRIVE, SUITE 101",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "77904",
            "telephone_number": "361-894-6835",
            "fax_number": "361-894-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEU",
        "first_name": "MELISSA",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2024-11-19",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "018498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "PHAM",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.