Provider Demographics
NPI:1467558569
Name:MEADOWS, CHARLES DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:DAVID
Last Name:MEADOWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4910 CRANBROOK DR E
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-4360
Mailing Address - Country:US
Mailing Address - Phone:817-277-1161
Mailing Address - Fax:817-261-8915
Practice Address - Street 1:900 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4730
Practice Address - Country:US
Practice Address - Phone:817-277-1161
Practice Address - Fax:817-261-8915
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD5794207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A4262OtherBCBS HEALTH PLAN
TX4053766OtherAETNA HEALTH PLAN
TX8976N0Medicare ID - Type Unspecified
TXD66960Medicare UPIN