Provider Demographics
NPI:1710761820
Name:MEINKE, ADALINE SUE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ADALINE
Middle Name:SUE
Last Name:MEINKE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3133 BUFFALO SPEEDWAY APT 4101
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1826
Mailing Address - Country:US
Mailing Address - Phone:713-397-8154
Mailing Address - Fax:
Practice Address - Street 1:23922 CINCO VILLAGE CENTER BLVD STE 230
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6620
Practice Address - Country:US
Practice Address - Phone:832-437-5866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123855225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist