Basic Information
| Provider Information | |||||||||
| NPI: | 1801048533 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEYER | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | RN, PNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3066 E COMMERCE ST | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782201013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102337000 | ||||||||
| FaxNumber: | 2102776387 | ||||||||
| Practice Location | |||||||||
| Address1: | 2810 DACY LN | ||||||||
| Address2: | |||||||||
| City: | KYLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786406322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122688900 | ||||||||
| FaxNumber: | 5122682250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2008 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | AP112857 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 321812502 | 05 | TX | MEDICAID |