=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184780041
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. ADAN MEAVE
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/28/2006
-----------------------------------------------------
Last Update Date | 03/05/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3622 MORELAND DR
-----------------------------------------------------
City | WESLACO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78596-9131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-968-7100
-----------------------------------------------------
Fax | 956-969-2400
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 712 W PAISANO LN
-----------------------------------------------------
City | WESLACO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78596-4131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-968-7100
-----------------------------------------------------
Fax | 956-969-2400
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number | 008591
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------