MEDICARE: MARY E MEYER MD

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	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	C50625	CA
2	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	J4353	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922076611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY E MEYER MD

Provider Business Mailing Address
First Line	:	8267 ELMBROOK DR
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75247-4030
Country	:	US
Telephone Number	:	214-237-1651
Fax Number	:	214-237-1743

Provider Business Practice Location Address
First Line	:	8267 ELMBROOK DR
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75247-4030
Country	:	US
Telephone Number	:	214-237-1665
Fax Number	:	214-631-6724

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	02/07/2008

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Directions to “ MARY E MEYER MD” Practice Location

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