Provider Demographics
NPI:1912534058
Name:GAMEZ, MEREDITH (PHMNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:
Last Name:GAMEZ
Suffix:
Gender:F
Credentials:PHMNP-BC
Other - Prefix:MS
Other - First Name:MEREDITH
Other - Middle Name:
Other - Last Name:GAMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHMNP-BC
Mailing Address - Street 1:5503 GROVE DR
Mailing Address - Street 2:
Mailing Address - City:SUNLAND PARK
Mailing Address - State:NM
Mailing Address - Zip Code:88063-9594
Mailing Address - Country:US
Mailing Address - Phone:915-922-8282
Mailing Address - Fax:
Practice Address - Street 1:1601 E YANDELL DR STE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5677
Practice Address - Country:US
Practice Address - Phone:915-887-3410
Practice Address - Fax:833-429-7587
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145661363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health