Provider Demographics
NPI:1033424189
Name:MEADOR, MICHAEL GREY JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:GREY
Last Name:MEADOR
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:929 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-5845
Mailing Address - Country:US
Mailing Address - Phone:817-596-7576
Mailing Address - Fax:817-594-7901
Practice Address - Street 1:929 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5845
Practice Address - Country:US
Practice Address - Phone:817-596-7576
Practice Address - Fax:817-594-7901
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2014-11-07
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGMedicare PIN