Provider Demographics
NPI:1306861299
Name:MERITZ, NEAL S (MD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:S
Last Name:MERITZ
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 1:525 OAK CENTRE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3917
Mailing Address - Country:US
Mailing Address - Phone:210-297-4550
Mailing Address - Fax:210-297-0450
Practice Address - Street 1:525 OAK CENTRE DR
Practice Address - Street 2:STE 150
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3917
Practice Address - Country:US
Practice Address - Phone:210-297-4550
Practice Address - Fax:210-297-0450
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9568207Q00000X
NMMD2013-0204207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141583801Medicaid
TX141583801Medicaid
TXA35904Medicare UPIN