Provider Demographics
NPI:1629271259
Name:HULSEY, MEREDITH ELAINE (DO)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:ELAINE
Last Name:HULSEY
Suffix:
Gender:F
Credentials:DO
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 2129
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79760-2129
Mailing Address - Country:US
Mailing Address - Phone:432-640-2346
Mailing Address - Fax:432-640-1337
Practice Address - Street 1:500 W 4TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-5059
Practice Address - Country:US
Practice Address - Phone:432-640-1000
Practice Address - Fax:432-640-1337
Is Sole Proprietor?:No
Enumeration Date:2007-06-10
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7283207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX199793405Medicaid
TX8ED509OtherBCBS TX
TX345679YZ45Medicare PIN