Provider Demographics
NPI:1922168749
Name:MEADE, VIRGINIA MARIE (DO)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:MARIE
Last Name:MEADE
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 691287
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-1287
Mailing Address - Country:US
Mailing Address - Phone:281-477-8660
Mailing Address - Fax:281-477-8662
Practice Address - Street 1:10655 STEEPLETOP DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4222
Practice Address - Country:US
Practice Address - Phone:281-477-8660
Practice Address - Fax:281-477-8662
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7783208000000X, 2080N0001X
TXL8834208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207003401Medicaid