Provider Demographics
NPI:1386881423
Name:MEEKS, DONALD WAYNE
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:WAYNE
Last Name:MEEKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 650865
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0865
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:972-715-9976
Practice Address - Street 1:6606 LBJ FWY STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6524
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX685737367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8873UGOtherBCBS
TXP00843881OtherRR MEDICARE
TX202784904Medicaid
TX202784903Medicaid
TX202784906Medicaid
TX8607UUOtherBCBS
TX8870UGOtherBCBS TX
TX202784905Medicaid
TX184792303Medicaid
TXP01446386OtherRR
TX202784904Medicaid
TX184792303Medicaid
TX202784903Medicaid
TX357832YK6UMedicare PIN
TX356320YK6UMedicare PIN