Provider Demographics
NPI:1184780041
Name:MEAVE, ADAN
Entity type:Individual
Prefix:MR
First Name:ADAN
Middle Name:
Last Name:MEAVE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 W PAISANO LN
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-4131
Mailing Address - Country:US
Mailing Address - Phone:956-968-7100
Mailing Address - Fax:956-969-2400
Practice Address - Street 1:3622 MORELAND DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-9131
Practice Address - Country:US
Practice Address - Phone:956-968-7100
Practice Address - Fax:956-969-2400
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0085913747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001012813Medicaid