Provider Demographics
NPI:1942442041
Name:EMILY S MEYER MD PA
Entity Type:Organization
Organization Name:EMILY S MEYER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:DEVOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-280-7943
Mailing Address - Street 1:1604 FM 1626
Mailing Address - Street 2:
Mailing Address - City:MANCHACA
Mailing Address - State:TX
Mailing Address - Zip Code:78652-3133
Mailing Address - Country:US
Mailing Address - Phone:512-280-7943
Mailing Address - Fax:512-291-5657
Practice Address - Street 1:3200 AVENUE E
Practice Address - Street 2:
Practice Address - City:HONDO
Practice Address - State:TX
Practice Address - Zip Code:78861-3525
Practice Address - Country:US
Practice Address - Phone:512-280-7943
Practice Address - Fax:512-291-5657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4353207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty