Provider Demographics
NPI:1023112489
Name:PALTER, GEOFFREY MEYER (MD)
Entity type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:MEYER
Last Name:PALTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 MSS MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MEXIA
Mailing Address - State:TX
Mailing Address - Zip Code:76667
Mailing Address - Country:US
Mailing Address - Phone:254-562-7635
Mailing Address - Fax:
Practice Address - Street 1:540 CHAPEL DRIVE
Practice Address - Street 2:MEXIA STATE SCHOOL
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667
Practice Address - Country:US
Practice Address - Phone:254-562-1801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9255207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G17094Medicare UPIN
TX8A2151Medicare ID - Type Unspecified