| Meridian Infectious Disease Consultants, Pllc | |
|
6100 Harris Pkwy Ste 205 Fort Worth TX 76132-4131 | |
| (817) 841-9447 | |
| Not Available |
| Full Name | Meridian Infectious Disease Consultants, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6100 Harris Pkwy Ste 205, Fort Worth, Texas |
| Authorized Official Name and Position | Ceres Tiu (OWNER / PROVIDER) |
| Authorized Official Contact | 8177186648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meridian Infectious Disease Consultants, Pllc 2830 S. Hulen St. #858 Fort Worth TX 76109-1514 Ph: (817) 718-6648 | Meridian Infectious Disease Consultants, Pllc 6100 Harris Pkwy Ste 205 Fort Worth TX 76132-4131 Ph: (817) 841-9447 |
| NPI Number | 1154992170 |
|---|---|
| Provider Enumeration Date | 07/09/2021 |
| Last Update Date | 05/19/2023 |
| Medicare PECOS PAC ID | 5395149462 |
|---|---|
| Medicare Enrollment ID | O20210811002538 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154992170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Ceres Tiu |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1891981171 PECOS PAC ID: 2961680780 Enrollment ID: I20140128001619 |
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