MEDICARE: STACY JAY MEEKS DC

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	111N00000X	Chiropractor	4690	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	:	1740284025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY JAY MEEKS DC

Provider Business Mailing Address
First Line	:	2101 N MIDLAND DR
Second Line	:	STE 6
City	:	MIDLAND
State	:	TX
Zip	:	79707-5593
Country	:	US
Telephone Number	:	432-697-8333
Fax Number	:	432-520-5220

Provider Business Practice Location Address
First Line	:	2101 N MIDLAND DR
Second Line	:	STE 6
City	:	MIDLAND
State	:	TX
Zip	:	79707-5593
Country	:	US
Telephone Number	:	432-520-8333
Fax Number	:	432-520-5220

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	07/06/2010

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Directions to “ STACY JAY MEEKS DC” Practice Location

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