Individual
MEREDITH L LIGHTFOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6124 W PARKER RD, STE 434, PLANO, TX 75093-8122
(214) 691-1902
(214) 987-1845
Mailing address
3600 GASTON AVE, SUITE 1205, DALLAS, TX 75246-1800
(214) 692-8262
(214) 696-4190
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
L2420
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160650101
—
TX
05
—
160650102
—
TX
01
—
8K1159
BCBS PROVIDER ID
—
01
—
P00004642
RRMCR OTHER
TX
01
—
P00046427
RRMCR
TX
Enumeration date
05/27/2006
Last updated
01/31/2017
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