Provider Demographics
NPI:1942034855
Name:THRASHER- IGORI, MELANIE REGINA
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:REGINA
Last Name:THRASHER- IGORI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:REGINA
Other - Last Name:OSBORNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4629 CHAPMAN ST
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-3107
Mailing Address - Country:US
Mailing Address - Phone:469-379-7405
Mailing Address - Fax:
Practice Address - Street 1:4925 WAMPLER DR
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-1024
Practice Address - Country:US
Practice Address - Phone:469-379-7405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)