Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 74 | TX |
N | 222Z00000X | Podiatrist | 74 | TX |
Y | 224P00000X | Prosthetist | 74 | TX |
NPI | 1356345243 |
---|---|
Provider Name | Douglas Ray Meyers |
First Address | Wichita Falls, TX 76301-4209 |
Second Address | Wichita Falls, TX 76301-4209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 16/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
107761201 | (05) | TX |
500218 | BLUE CROSS BLUE SHIELD (01) | TX |
752207607 | ALL HEALTH INSURANCE (01) | TX |
752207607 | TRICARE (01) | TX |