Provider Demographics
NPI:1891976940
Name:MCMEANS, ROXANNE M
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:M
Last Name:MCMEANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5574 N FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-1108
Mailing Address - Country:US
Mailing Address - Phone:210-666-9268
Mailing Address - Fax:210-661-2804
Practice Address - Street 1:5574 N FOSTER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78244-1108
Practice Address - Country:US
Practice Address - Phone:210-666-9268
Practice Address - Fax:210-661-2804
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010591251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679667Medicare Oscar/Certification