Provider Demographics
NPI:1558454645
Name:KREBEL, MEREDITH S (MD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:S
Last Name:KREBEL
Suffix:
Gender:F
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:PO BOX 99213
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0213
Mailing Address - Country:US
Mailing Address - Phone:682-885-1860
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:2727 E SOUTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6613
Practice Address - Country:US
Practice Address - Phone:682-885-6000
Practice Address - Fax:682-885-6050
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9138207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3841568OtherCIGNA PIN
TX5032409OtherAETNA PIN
TX117113101OtherFIRSTCARE PIN
TX118356803Medicaid
TX124224OtherSUPERIOR PIN
1669442042OtherGRP NPI NUMBER
TX118356802Medicaid
TX137283103Medicaid
TX1392764OtherUHC PIN
TX413468OtherPHCS PIN
TX83X064OtherBCBSTX IND PIN
TX137345805Medicaid
TX1640373OtherFIRSTHEALTH PIN
TX00L42VOtherBCBSTX GRP PIN
TX10028760OtherAMERIGROUP PIN
TX137283103Medicaid
TX118356802Medicaid
TX124224OtherSUPERIOR PIN