Healthcare Provider Details

I. General information

NPI: 1164487617
Provider Name (Legal Business Name): CALVIN EINAR MEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 SPURS LN
SAN ANTONIO TX
78240-1669
US

IV. Provider business mailing address

PO BOX 737507
DALLAS TX
75373-7507
US

V. Phone/Fax

Practice location:
  • Phone: 800-833-5921
  • Fax: 713-513-5613
Mailing address:
  • Phone: 800-833-5921
  • Fax: 713-513-5613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberF7842
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberF7842
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: