Provider Demographics
NPI:1316969249
Name:JOSEPH L. MEZA
Entity type:Organization
Organization Name:JOSEPH L. MEZA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MEZA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:281-334-2560
Mailing Address - Street 1:PO BOX 1193
Mailing Address - Street 2:
Mailing Address - City:KEMAH
Mailing Address - State:TX
Mailing Address - Zip Code:77565-1193
Mailing Address - Country:US
Mailing Address - Phone:281-334-2560
Mailing Address - Fax:281-238-8401
Practice Address - Street 1:3000 INVINCIBLE CIR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2956
Practice Address - Country:US
Practice Address - Phone:281-334-2560
Practice Address - Fax:281-238-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX143867225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID