Provider Demographics
NPI:1598970311
Name:JOSEPH A. MEACHAM, M.D., P.A.
Entity Type:Organization
Organization Name:JOSEPH A. MEACHAM, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MEACHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-320-3800
Mailing Address - Street 1:9330 POPPY DR
Mailing Address - Street 2:SUITE 506
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-4621
Mailing Address - Country:US
Mailing Address - Phone:214-320-3800
Mailing Address - Fax:214-320-4968
Practice Address - Street 1:9330 POPPY DR
Practice Address - Street 2:SUITE 506
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-4621
Practice Address - Country:US
Practice Address - Phone:214-320-3800
Practice Address - Fax:214-320-4968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3159174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085759101Medicaid
TXCG1523OtherRAILROAD MEDICARE
TX00U732Medicare ID - Type Unspecified
TX085759101Medicaid