Provider Demographics
NPI:1114982915
Name:MEYER, DAN MARSHALL (MD)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:MARSHALL
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3400 W WHEATLAND RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-4408
Mailing Address - Country:US
Mailing Address - Phone:214-884-4700
Mailing Address - Fax:214-884-4762
Practice Address - Street 1:1222 N BISHOP AVE STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4176
Practice Address - Country:US
Practice Address - Phone:214-941-1353
Practice Address - Fax:214-941-1047
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8628208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FW428OtherBLUE CROSS
E92900Medicare UPIN
TX488226YKQJMedicare PIN