MEDICARE: MEREDITH FURST HORACEK 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	207W00000X	Ophthalmology Physician	125.076507	IL
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207W00000X	Ophthalmology Physician	V3323	TX

General Provider Information

NPI Number	:	1902433378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEREDITH FURST HORACEK MD

Provider Business Mailing Address
First Line	:	21502 MERCHANTS WAY
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-2517
Country	:	US
Telephone Number	:	281-579-6777
Fax Number	:

Provider Business Practice Location Address
First Line	:	21502 MERCHANTS WAY
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-2517
Country	:	US
Telephone Number	:	281-579-6777
Fax Number	:

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

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	09/12/2024

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