Healthcare Provider Details

I. General information

NPI: 1609731819
Provider Name (Legal Business Name): MERIDIAN HEALTH POST ACUTE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 W BETHANY DR STE 570
ALLEN TX
75013-3845
US

IV. Provider business mailing address

950 W BETHANY DR STE 570
ALLEN TX
75013-3845
US

V. Phone/Fax

Practice location:
  • Phone: 844-941-3087
  • Fax: 844-593-1570
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GRADY GOODWIN
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 214-564-2510