Healthcare Provider Details

I. General information

NPI: 1033840251
Provider Name (Legal Business Name): MERIDITH LYNN BUZBEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2022
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W 5TH ST
ODESSA TX
79763-4206
US

IV. Provider business mailing address

701 W 5TH ST
ODESSA TX
79763-4206
US

V. Phone/Fax

Practice location:
  • Phone: 432-703-5083
  • Fax:
Mailing address:
  • Phone: 432-703-5083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: