Provider Demographics
NPI:1245414390
Name:EMILY S. MEYER, MD, PA
Entity Type:Organization
Organization Name:EMILY S. MEYER, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:S
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-426-7444
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:
Mailing Address - City:HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78861-0858
Mailing Address - Country:US
Mailing Address - Phone:830-426-7444
Mailing Address - Fax:
Practice Address - Street 1:3200 AVENUE E
Practice Address - Street 2:
Practice Address - City:HONDO
Practice Address - State:TX
Practice Address - Zip Code:78861-3525
Practice Address - Country:US
Practice Address - Phone:830-426-7444
Practice Address - Fax:830-426-7468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4353207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX209663801Medicaid
TXDP7679OtherMEDICARE RAILROAD
TXDP7679OtherMEDICARE RAILROAD