Provider Information for 1265165443
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MEREDITH BAUER
Sex: Female
NPI: 1265165443
Last Updated: 2024-09-25
Certification Date: 2024-09-25
Certification Date: 2024-09-25
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1265165443 | ||||||||
| Enumeration Date | 2022-07-06 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 9846 HWY 31 E TYLER, TX 75705-2329 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 610 N LOOP 336 E STE 200 CONROE, TX 77301-1437 United States Phone: 832-420-1037 | Fax: | ||||||||
| Secondary Practice Address(es) | 18 MEADOW STAR CT | ||||||||
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