Healthcare Provider Details

I. General information

NPI: 1093798167
Provider Name (Legal Business Name): LINDA A MEREDITH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 W BLUE STARR DR
CLAREMORE OK
74017-2544
US

IV. Provider business mailing address

1108 LAVACA ST SUITE 110-320
AUSTIN TX
78701-2172
US

V. Phone/Fax

Practice location:
  • Phone: 918-342-5432
  • Fax: 918-342-0835
Mailing address:
  • Phone: 512-477-4088
  • Fax: 512-482-0390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number255985
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number118969
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: