Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1135382 | TX |
N | 2251G0304X | Physical Therapist - Geriatrics | 1135382 | TX |
NPI | 1063925204 |
---|---|
Provider Name | Damon Will Meekins |
First Address | Coppell, TX 75019-6635 |
Second Address | Coppell, TX 75019-6635 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2017 |
Last Update Date | 09/11/2017 |