Provider Demographics
NPI:1760213474
Name:MEADE, ROY ALLEN (PT)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:ALLEN
Last Name:MEADE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6912 AVENUE P
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-1225
Mailing Address - Country:US
Mailing Address - Phone:832-314-2946
Mailing Address - Fax:
Practice Address - Street 1:6912 AVENUE P
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-1225
Practice Address - Country:US
Practice Address - Phone:832-314-2946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1086874208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation