Healthcare Provider Details

I. General information

NPI: 1952343493
Provider Name (Legal Business Name): MEREDITH A BYINGTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEREDITH A GROESBECK

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 07/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 W HIGHWAY 175
CRANDALL TX
75114
US

IV. Provider business mailing address

1025 W HIGHWAY 175
CRANDALL TX
75114
US

V. Phone/Fax

Practice location:
  • Phone: 972-472-3800
  • Fax: 972-472-3828
Mailing address:
  • Phone: 972-472-3800
  • Fax: 972-472-3828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM1037
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: