Provider Demographics
NPI:1073931341
Name:MESHKOV, DMITRIY (MD)
Entity Type:Individual
Prefix:
First Name:DMITRIY
Middle Name:
Last Name:MESHKOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DMITRIY
Other - Middle Name:
Other - Last Name:SCHWARZBURG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7009 ALMEDA RD APT 1230
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2182
Mailing Address - Country:US
Mailing Address - Phone:713-653-4094
Mailing Address - Fax:
Practice Address - Street 1:7009 ALMEDA RD APT 1230
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2182
Practice Address - Country:US
Practice Address - Phone:713-653-4094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY2814032085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program