Provider Demographics
NPI:1396790887
Name:ADAMS, MEREDITH MICHELLE (DO)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:MICHELLE
Last Name:ADAMS
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 1:2990 LEGACY DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6066
Mailing Address - Country:US
Mailing Address - Phone:469-888-5152
Mailing Address - Fax:469-888-5163
Practice Address - Street 1:2990 LEGACY DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6066
Practice Address - Country:US
Practice Address - Phone:469-888-5152
Practice Address - Fax:469-888-5163
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4206208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165463401Medicaid
TX165463404Medicaid
TX8BN841OtherBCBS
TX165463402Medicaid
TX8F5121OtherBCBS
8F5121OtherBCBS
TX8F5121OtherBCBS
TXTXB110034Medicare PIN
TX8L2999Medicare PIN
TX8B6703Medicare PIN
TX165463401Medicaid