Provider Demographics
NPI:1376639377
Name:MEEKS, CLYDE A (MD)
Entity Type:Individual
Prefix:DR
First Name:CLYDE
Middle Name:A
Last Name:MEEKS
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 1:1301 S. COULTER
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106
Mailing Address - Country:US
Mailing Address - Phone:806-355-6330
Mailing Address - Fax:806-351-0950
Practice Address - Street 1:1301 S. COULTER
Practice Address - Street 2:SUITE 300
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106
Practice Address - Country:US
Practice Address - Phone:806-355-6330
Practice Address - Fax:806-351-0950
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6427207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF34701Medicare UPIN
TX83Y326Medicare ID - Type Unspecified