Provider Demographics
NPI:1881639474
Name:RICARDO MEADE MD PA
Entity Type:Organization
Organization Name:RICARDO MEADE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRITZ
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:214-823-1691
Mailing Address - Street 1:9101 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5956
Mailing Address - Country:US
Mailing Address - Phone:214-823-1691
Mailing Address - Fax:214-821-7089
Practice Address - Street 1:9101 N CENTRAL EXPY
Practice Address - Street 2:SUITE 600
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5956
Practice Address - Country:US
Practice Address - Phone:214-823-1691
Practice Address - Fax:214-821-7089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1235208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202405101Medicaid
TX0026NWOtherBLUE CROSS BLUE SHIELD
TX8F8834Medicare PIN
TX00Z629Medicare PIN
TX202405101Medicaid