Rouse, Wildon Mellinger

Rouse, Wildon Mellinger is an individual health care provider with primary practice located at 1253 N Von Minden St , La Grange TX 78945-1262. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Rouse, Wildon Mellinger can be contacted via phone (979) 968-8493.

Contact Information

Primary practice address
1253 N Von Minden St La Grange TX 78945-1262
Phone: (979) 968-8493
Fax: (979) 968-6388
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA02598 Texas

Profile Details

NPI number 1003873845
LBN Legal business name Rouse, Wildon Mellinger
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Dec 4th, 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 1003873845 NPPES
Texas Other MDF1715TX WORKERS COMPENSATION
Texas MEDICAID 308464202 WORKERS COMPENSATION
Texas Other 875N33 WORKERS COMPENSATION
Texas Other P00477542 WORKERS COMPENSATION

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