Provider Demographics
NPI:1689670184
Name:AMAR, MEERA (MD)
Entity Type:Individual
Prefix:
First Name:MEERA
Middle Name:
Last Name:AMAR
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 1:333 LONDONDERRY DRIVE SUITE # 200
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712
Mailing Address - Country:US
Mailing Address - Phone:254-751-9777
Mailing Address - Fax:254-751-9988
Practice Address - Street 1:333 LONDONDERRY DRIVE SUITE # 200
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712
Practice Address - Country:US
Practice Address - Phone:254-751-9777
Practice Address - Fax:254-751-9988
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2630207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097864501Medicaid
TX8355K0Medicare ID - Type Unspecified
TX097864501Medicaid