Basic Information
| Provider Information | |||||||||
| NPI: | 1558667311 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KITAGAWA | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | GWENDOLYN | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FEARING | ||||||||
| OtherFirstName: | MELANIE | ||||||||
| OtherMiddleName: | GWENDOLYN | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6621 FANNIN ST | ||||||||
| Address2: | SUITE W6006 TEXAS CHILDRENS HOSPITAL CRITICAL CARE | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8328266230 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6621 FANNIN ST | ||||||||
| Address2: | SUITE W6006 TEXAS CHILDRENS HOSPITAL CRITICAL CARE | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8328266230 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2011 | ||||||||
| LastUpdateDate: | 07/02/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0203X | P6009 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine |
No ID Information.