Provider Demographics
NPI:1740284025
Name:MEEKS, STACY JAY (DC)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:JAY
Last Name:MEEKS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 N MIDLAND DR
Mailing Address - Street 2:STE 6
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-5593
Mailing Address - Country:US
Mailing Address - Phone:432-697-8333
Mailing Address - Fax:432-520-5220
Practice Address - Street 1:2101 N MIDLAND DR
Practice Address - Street 2:STE 6
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-5593
Practice Address - Country:US
Practice Address - Phone:432-520-8333
Practice Address - Fax:432-520-5220
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-02
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0015075-01Medicaid
TX603152Medicare ID - Type UnspecifiedMEDICARE-TEXAS
T91070Medicare UPIN