Provider Demographics
NPI:1710967831
Name:MEANEY, JOAN T (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:T
Last Name:MEANEY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7434 LOUIS PASTEUR DR
Mailing Address - Street 2:STE 215
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4540
Mailing Address - Country:US
Mailing Address - Phone:210-463-9642
Mailing Address - Fax:855-783-1225
Practice Address - Street 1:7434 LOUIS PASTEUR DR
Practice Address - Street 2:STE 215
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4540
Practice Address - Country:US
Practice Address - Phone:210-463-9642
Practice Address - Fax:855-783-1225
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2019-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH4546208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126427705Medicaid
TXF58583Medicare UPIN
TX8514M0Medicare ID - Type Unspecified