MEDICARE: DR. RANDALL DAVID MEYER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	22282	TX

General Provider Information

NPI Number	:	1114133840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RANDALL DAVID MEYER DDS

Provider Business Mailing Address
First Line	:	3109 OLTON RD STE 302C
Second Line	:	WINCHESTER PLAZA BOX 5027
City	:	PLAINVIEW
State	:	TX
Zip	:	79072-6763
Country	:	US
Telephone Number	:	806-296-7666
Fax Number	:	806-296-7673

Provider Business Practice Location Address
First Line	:	715 N 64TH ST
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-4387
Country	:	US
Telephone Number	:	254-772-3922
Fax Number	:	254-776-6230

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	12/11/2025

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