Provider Demographics
NPI:1205820479
Name:MEISER, JOHN B (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:MEISER
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 1:6946 LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6741
Mailing Address - Country:US
Mailing Address - Phone:972-377-9987
Mailing Address - Fax:972-377-9906
Practice Address - Street 1:6946 LEBANON RD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6741
Practice Address - Country:US
Practice Address - Phone:972-377-9987
Practice Address - Fax:972-377-9906
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1258174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1421711-01Medicaid
TX8V8610OtherBCBS
LA1756474Medicaid
OK200032370AMedicaid