Provider Demographics
NPI:1427231596
Name:JIAN HUAN MENG MD PA
Entity Type:Organization
Organization Name:JIAN HUAN MENG MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIAN HUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-398-3666
Mailing Address - Street 1:PO BOX 250491
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-0491
Mailing Address - Country:US
Mailing Address - Phone:972-398-3666
Mailing Address - Fax:972-398-6667
Practice Address - Street 1:400 MAPLELAWN DR STE 101
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-5744
Practice Address - Country:US
Practice Address - Phone:972-398-3666
Practice Address - Fax:972-398-6667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6151207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173115001Medicaid
TX0306524-02Medicaid
TX8C2713Medicare PIN
TX0306524-02Medicaid
TXG82674Medicare UPIN