Healthcare Provider Details

I. General information

NPI: 1902350739
Provider Name (Legal Business Name): MEYA SRITHAPIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2016
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 DENALI PASS STE 601
CEDAR PARK TX
78613-7980
US

IV. Provider business mailing address

507 DENALI PASS STE 601
CEDAR PARK TX
78613-7980
US

V. Phone/Fax

Practice location:
  • Phone: 512-284-7077
  • Fax:
Mailing address:
  • Phone: 972-977-8098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number66362
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2025-0328
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22993
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: