Provider Demographics
NPI:1043242308
Name:MEEK, THOMAS D (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:D
Last Name:MEEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 PRESTWICK
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-5200
Mailing Address - Country:US
Mailing Address - Phone:432-332-0478
Mailing Address - Fax:432-687-6298
Practice Address - Street 1:511 N ALLEGHANEY AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4405
Practice Address - Country:US
Practice Address - Phone:432-332-0478
Practice Address - Fax:432-687-6298
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3510207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD3510OtherTX LICENSE
TX131577206Medicaid
TXTXB101336Medicare PIN
TXD3510OtherTX LICENSE