Healthcare Provider Details

I. General information

NPI: 1952715666
Provider Name (Legal Business Name): JEFFREY MYERS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2014
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 MITCHELL BLVD BLDG 375
LAUGHLIN AFB TX
78843-5242
US

IV. Provider business mailing address

590 MITCHELL BLVD BLDG 375
LAUGHLIN AFB TX
78843-5242
US

V. Phone/Fax

Practice location:
  • Phone: 830-298-6333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number34.012.021
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34.012021
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: