Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | D3510 | TX |
NPI | 1043242308 |
---|---|
Provider Name | Thomas D Meek |
First Address | Odessa, TX 79762-5200 |
Second Address | Odessa, TX 79761-4405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 06/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131577206 | (05) | TX |
B24821 | (02) | TX |
D3510 | TX LICENSE (01) | TX |