Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | L5050 | TX |
NPI | 1053350819 |
---|---|
Provider Name | Micah S Meyer |
First Address | Waco, TX 76708-3003 |
Second Address | Waco, TX 76708-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 27/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
152881201 | (05) | TX |
H67373 | (02) |