Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | 01074060A | IN |
Y | 2080P0205X | Pediatric Endocrinologist | N8818 | TX |
NPI | 1124375969 |
---|---|
Provider Name | Adelina G. Meadows |
First Address | Dallas, TX 75284-6098 |
Second Address | Tyler, TX 75701-1833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2012 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201230860 | (05) | IN |
379806801 | (05) | TX |
8HF356 | BCBS (01) | TX |
P01938229 | MEDICARE RAIL ROAD (01) | TX |