MEDICARE: LAURA ANN MERITT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	J2683	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316949605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA ANN MERITT MD

Provider Business Mailing Address
First Line	:	12201 RENFERT WAY
Second Line	:	STE 205
City	:	AUSTIN
State	:	TX
Zip	:	78758-5369
Country	:	US
Telephone Number	:	512-339-6626
Fax Number	:	512-425-3809

Provider Business Practice Location Address
First Line	:	12201 RENFERT WAY
Second Line	:	STE 205
City	:	AUSTIN
State	:	TX
Zip	:	78758-5369
Country	:	US
Telephone Number	:	512-339-6626
Fax Number	:	512-425-3809

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	05/15/2014

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Directions to “ LAURA ANN MERITT MD” Practice Location

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