Provider Demographics
NPI:1346671716
Name:NUNLEY, MEREDITH CLAIRE (PA-C)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:CLAIRE
Last Name:NUNLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:CLAIRE
Other - Last Name:HARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:9780 LBJ FWY STE 124
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6847
Mailing Address - Country:US
Mailing Address - Phone:469-317-0028
Mailing Address - Fax:214-341-7707
Practice Address - Street 1:9780 LBJ FWY STE 124
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6847
Practice Address - Country:US
Practice Address - Phone:469-317-0028
Practice Address - Fax:214-341-7707
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1115805363A00000X
TXPA09056363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant