Basic Information
| Provider Information | |||||||||
| NPI: | 1912149121 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOHN W. MEYER M D PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1604 FM 1626 | ||||||||
| Address2: | |||||||||
| City: | MANCHACA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122807943 | ||||||||
| FaxNumber: | 5122915657 | ||||||||
| Practice Location | |||||||||
| Address1: | 3200 AVENUE E | ||||||||
| Address2: | |||||||||
| City: | HONDO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 788613525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122807943 | ||||||||
| FaxNumber: | 5122915657 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2009 | ||||||||
| LastUpdateDate: | 01/30/2014 | ||||||||
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| AuthorizedOfficialLastName: | DEVOS | ||||||||
| AuthorizedOfficialFirstName: | CAROLE | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | CONTRACTING AGENT | ||||||||
| AuthorizedOfficialTelephone: | 5122807943 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | E3732 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.