Agustin Melendez Jr., ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT7692 Issued in TX

Practice address

4301 Broadway St
San Antonio, TX 78209-6318

Phone

(210) 829-3834

NPI assigned

Oct 24, 2018

Last updated

Oct 24, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1134696552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15651 CHASE HILL BLVD APT 1510",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782561070",
            "telephone_number": "409-457-5817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 BROADWAY ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782096318",
            "telephone_number": "210-829-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ",
        "first_name": "AGUSTIN",
        "name_suffix": "Jr.",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-24",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT7692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEPARTMENT OF LICENSING & REGULATION",
            "identifier": "AT7692",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Melchor, LCDC
• Maria Louisa Melchor
• Sandra Powell Melchor, CCP
• Vanesa Joseline Melchor
• Celia Marie Melecio, LCSW
• Andrea Melendez
• Carlos Jovaney Melendez, NP
• Deanna Melendez, LCDC
• Eliana Melendez, DDS
• Emairany Melendez

• Athletic Trainer in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.