DR. MERRITT BONAR TEDDLIE


Address: 7830 Meadow Park Dr, 108, Dallas, TX 75230-4942
Phone: 2144609132

DR. MERRITT BONAR TEDDLIE (NPI# 1720427057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720427057
Entity Type Individual
Full Name DR. MERRITT BONAR TEDDLIE
Credential MD
Practice Address 7830 Meadow Park Dr
108
Dallas
TX 75230-4942
Practice Telephone 2144609132
Mailing Telephone 2144609132
Enumeration Date 2013-06-20
Last Update Date 2013-06-20
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208D00000X General Practice C8467 TX Allopathic & Osteopathic Physicians

Office Location

Street Address 7830 MEADOW PARK DR
108
City DALLAS
State TX
Zip Code 75230-4942

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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

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1922542075 Liferestore Md Usa LLC General Practice 3910 Gaston Ave Ste 140, Dallas, TX 75246-1523 2016-12-08
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1679983480 Nathaniel Ott General Practice 810 Turner Ave, Dallas, TX 75208-3737 2014-05-01
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Competitor

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City DALLAS
Zip Code 75230

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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