Provider Demographics
NPI:1386939981
Name:MAYO, MEREDITH ANNE ROBEY (PA-C)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ANNE ROBEY
Last Name:MAYO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7617 LA RISA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4336
Mailing Address - Country:US
Mailing Address - Phone:713-705-3971
Mailing Address - Fax:
Practice Address - Street 1:2800 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7526
Practice Address - Country:US
Practice Address - Phone:713-705-3971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant