Provider Demographics
NPI:1427014539
Name:AULDS, MERIA G (MD)
Entity Type:Individual
Prefix:MRS
First Name:MERIA
Middle Name:G
Last Name:AULDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MERIA
Other - Middle Name:
Other - Last Name:MANTINOSSIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1816 S FM 51
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3784
Mailing Address - Country:US
Mailing Address - Phone:940-626-0052
Mailing Address - Fax:940-626-0082
Practice Address - Street 1:1816 S FM 51
Practice Address - Street 2:SUITE 1200
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3784
Practice Address - Country:US
Practice Address - Phone:940-626-0052
Practice Address - Fax:940-626-0082
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4521207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173219001Medicaid
TX8AJ579OtherBCBS
TX173219001Medicaid
G41276Medicare UPIN