Healthcare Provider Details

I. General information

NPI: 1083674576
Provider Name (Legal Business Name): THOMAS H. MEADE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N BEAVER ST
FLAGSTAFF AZ
86001-3118
US

IV. Provider business mailing address

1721 BIRMINGHAM RD STE 202
COLLEGE STATION TX
77845-4081
US

V. Phone/Fax

Practice location:
  • Phone: 928-226-6400
  • Fax:
Mailing address:
  • Phone: 979-446-0373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberK9614
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberK9614
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number77523
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: