Provider Demographics
NPI:1912107756
Name:BRENDA MEEKS, PH.D., P.A.
Entity Type:Organization
Organization Name:BRENDA MEEKS, PH.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-342-3500
Mailing Address - Street 1:PO BOX 3087
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79116-3087
Mailing Address - Country:US
Mailing Address - Phone:806-342-3500
Mailing Address - Fax:806-374-8832
Practice Address - Street 1:1216 S GEORGIA ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79102-1310
Practice Address - Country:US
Practice Address - Phone:806-342-3500
Practice Address - Fax:806-374-8832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25791103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y491Medicare PIN