MEDICARE: DR. MEENA JOSEPH M.D.

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	207R00000X	Internal Medicine Physician	Q9836	TX

General Provider Information

NPI Number	:	1134192792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEENA JOSEPH M.D.

Provider Business Mailing Address
First Line	:	2529 S 1ST ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-5466
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2529 S 1ST ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-5466
Country	:	US
Telephone Number	:	512-978-9500
Fax Number	:	512-901-9708

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	11/03/2017

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