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General NPI Number Information
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NPI Number | 1649302274
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Entity Type | Individual
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Provider Name | BRIAN LEE MEADORS PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1400 8TH AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-4110
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Country | US
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Telephone | 817-927-6141
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Fax |
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Provider Business Mailing Address
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Address Line | 10653 HIGHLAND RIDGE RD
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City | FORT WORTH
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State | TX
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Zip | 76108-6916
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Country | US
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Telephone | 817-244-9508
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 43337
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License Number State | TX
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