Provider Demographics
NPI:1063911956
Name:JENKINS, MELODY M (DC)
Entity type:Individual
Prefix:DR
First Name:MELODY
Middle Name:M
Last Name:JENKINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16715 ROCKWALL ST
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77303-2071
Mailing Address - Country:US
Mailing Address - Phone:832-877-1574
Mailing Address - Fax:
Practice Address - Street 1:3702 CYPRESS CREEK PKWY STE O
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3518
Practice Address - Country:US
Practice Address - Phone:281-836-6664
Practice Address - Fax:281-836-5396
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13713111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty