Provider Demographics
NPI:1467709485
Name:TY ARIAS, MEI AN TONETTE O
Entity Type:Individual
Prefix:DR
First Name:MEI AN TONETTE
Middle Name:O
Last Name:TY ARIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEI AN TONETTE
Other - Middle Name:O
Other - Last Name:TY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1600 REPUBLIC PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-6919
Mailing Address - Country:US
Mailing Address - Phone:972-288-2600
Mailing Address - Fax:972-288-8886
Practice Address - Street 1:1600 REPUBLIC PKWY STE 200
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6919
Practice Address - Country:US
Practice Address - Phone:972-288-2600
Practice Address - Fax:972-288-8886
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ9756207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX535865YYSGMedicare PIN