Healthcare Provider Details

I. General information

NPI: 1396600953
Provider Name (Legal Business Name): MERIDEN OVERALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 PRECINCT LINE RD
HURST TX
76053-5417
US

IV. Provider business mailing address

625 CIRCLEVIEW DR S
HURST TX
76054-3459
US

V. Phone/Fax

Practice location:
  • Phone: 817-399-2733
  • Fax:
Mailing address:
  • Phone: 817-939-3290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number81812
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: