Provider Demographics
NPI:1154369676
Name:MERIA G AULDS, MD, PA
Entity type:Organization
Organization Name:MERIA G AULDS, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MERIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:AULDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-626-0052
Mailing Address - Street 1:2014 BEN MERRITT DR
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3850
Mailing Address - Country:US
Mailing Address - Phone:940-626-0052
Mailing Address - Fax:940-626-0082
Practice Address - Street 1:2014 BEN MERRITT DR
Practice Address - Street 2:SUITE A-2
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3850
Practice Address - Country:US
Practice Address - Phone:940-626-0052
Practice Address - Fax:940-626-0082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0067QJOtherBCBS
DD5385OtherMEDICARE RAILROAD
TX00599YMedicare PIN