Provider Demographics
NPI:1063114924
Name:MEADOWS, CHARLEY WAUGH (DO)
Entity type:Individual
Prefix:
First Name:CHARLEY
Middle Name:WAUGH
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL CITY ARLINGTON
Mailing Address - Street 2:3301 MATLOCK ROAD
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015
Mailing Address - Country:US
Mailing Address - Phone:682-220-4073
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL CITY ARLINGTON
Practice Address - Street 2:3301 MATLOCK ROAD
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015
Practice Address - Country:US
Practice Address - Phone:682-220-4073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program