Organization Active NPI

Melrose Clinic, PLLC

  • Internal Medicine Physician
  • Richardson, TX
National Provider Identifier
1457897621
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MELROSE CLINIC, PLLC
Practice address
331 Melrose Dr
Suite 220
Richardson, TX 75080-4405
Phone
(469) 828-1903
NPI assigned
Jan 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Authorized official

Name
Dr. Henry Allen, M.D.NPI 1710900527
Title
Partner
Phone
(469) 828-1903

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Multi-Specialty Clinic/Center 261QM1300X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

331 Melrose Dr
Suite 220
Richardson, TX 75080-4405

Mailing address

331 Melrose Dr
Suite 220
Richardson, TX 75080-4405
Phone (469) 828-1903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170410002539 TX Part B Supplier - Clinic/Group Practice 4284910092 Receives reassigned benefits from 2 practitioners
Practice locations: Richardson, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1457897621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 MELROSE DR",
            "address_2": "SUITE 220",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750804405",
            "telephone_number": "469-828-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 MELROSE DR",
            "address_2": "SUITE 220",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750804405",
            "telephone_number": "469-828-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELROSE CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "469-828-1903",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.