Provider Demographics
NPI:1649058777
Name:MEADOWS, KRISTYN
Entity type:Individual
Prefix:
First Name:KRISTYN
Middle Name:
Last Name:MEADOWS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S SHILOH RD STE 333
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-8235
Mailing Address - Country:US
Mailing Address - Phone:972-864-2050
Mailing Address - Fax:
Practice Address - Street 1:711 E LAMAR BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-3800
Practice Address - Country:US
Practice Address - Phone:817-795-7546
Practice Address - Fax:817-385-7568
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1136615363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily