Basic Information
Provider Information
NPI: 1730168444
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEISTER
FirstName: KEITH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3533 MATLOCK RD
Address2:  
City: ARLINGTON
State: TX
PostalCode: 760153604
CountryCode: US
TelephoneNumber: 8174190303
FaxNumber: 8174685963
Practice Location
Address1: 3533 MATLOCK RD
Address2:  
City: ARLINGTON
State: TX
PostalCode: 760153604
CountryCode: US
TelephoneNumber: 8174190303
FaxNumber: 8174685963
Other Information
ProviderEnumerationDate: 01/11/2006
LastUpdateDate: 06/12/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XX0005XL8431TXY Allopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine

No ID Information.


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