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MELVILLE MEDICINE, PLLC
NPI 1043873771
Family Medicine in Southlake, TX

Active since April 18, 2019CLIA 45D2166939 · Waiver
1545 E SOUTHLAKE BLVD STE 110, SOUTHLAKE, TX 76092(817) 600-8725 Get Directions Write a Review

NPPES record last updated: December 2, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 2, 2022, Oct 30, 2020, Apr 18, 2019 (3 updates tracked since 2019).

About Melville Medicine, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MELVILLE MEDICINE, PLLC (NPI 1043873771) is a healthcare organization registered as a family medicine in Southlake, Texas and active in the NPI registry since April 2019. The organization holds a CLIA Waiver certificate valid through May 29, 2027 and lists Daniel Melville, Member, as its authorized official.

NPPES Registry Identity

NPI1043873771
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMELVILLE MEDICINE, PLLC
Location Address1545 E SOUTHLAKE BLVD STE 110Southlake, TX 76092-6464
Mailing Address1545 E Southlake Blvd Ste 110Southlake, TX 76092-6464 · (817) 676-2010 · Fax (833) 989-2353
Phone(817) 600-8725
Organization SubpartNo
Authorized OfficialDaniel MelvilleMember · (817) 600-8725
Enumeration DateApril 18, 2019
Last NPPES UpdateDecember 2, 20223 updates tracked since enumeration
NPPES CertifiedDecember 2, 2022
✔ NPI 1043873771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X
1545 E SOUTHLAKE BLVD STE 110, Southlake, TX 76092
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2166939

Melville Medicine, PLLC · Southlake, TX
Active · expires May 29, 2027
CLIA Number45D2166939
Laboratory TypePhysician Office
Certificate Effective DateMay 30, 2025
Certificate Expiration DateMay 29, 2027
Laboratory DirectorDaniel E. Melville
Laboratory Phone(817) 767-2110
Laboratory LocationMelville Medicine, PLLC1545 East Southlake Blvd Suite 110, Southlake, TX 76092
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DANIEL ELIAS MELVILLE MD
Family Medicine
1545 E SOUTHLAKE BLVD STE 110
SOUTHLAKE, TX 76092
Tarrant County (817) 600-8725

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Melville Medicine, PLLC's NPI number?

The NPI number for Melville Medicine, PLLC is 1043873771. It was assigned to this organization in the NPPES registry on April 18, 2019.

Where is Melville Medicine, PLLC located?

Melville Medicine, PLLC is located at 1545 E Southlake Blvd Ste 110, Southlake, TX 76092. The listed phone number is (817) 600-8725.

What is Melville Medicine, PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Melville Medicine, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2166939) is associated with this NPI, valid through May 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Melville Medicine, PLLC was last updated on December 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.