Provider Demographics
NPI:1568667962
Name:MEUSA, ASHLEY K (DPM)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:K
Last Name:MEUSA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2922 B- MLK BLVD.
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75215
Mailing Address - Country:US
Mailing Address - Phone:214-426-3645
Mailing Address - Fax:
Practice Address - Street 1:2922 MLK JR BLVD BLDG B
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-2321
Practice Address - Country:US
Practice Address - Phone:214-426-3645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1816213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187218601Medicaid
TXP00450854OtherRAIL RD. MEDICARE
TX187218602Medicaid
TX187218602Medicaid
TX8J7621Medicare PIN
TXP00450854OtherRAIL RD. MEDICARE
TX187218601Medicaid