Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | J9138 | TX |
NPI | 1558454645 |
---|---|
Provider Name | Meredith S Krebel |
First Address | Fort Worth, TX 76199-0213 |
Second Address | Southlake, TX 76092-6613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 04/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F41981 | (02) |