Provider Demographics
NPI:1679386874
Name:BURRES, MEREDITH ANNE
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ANNE
Last Name:BURRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 E PARK ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4598
Mailing Address - Country:US
Mailing Address - Phone:512-588-1362
Mailing Address - Fax:512-792-4834
Practice Address - Street 1:2105 E PARK ST
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4598
Practice Address - Country:US
Practice Address - Phone:512-588-1362
Practice Address - Fax:512-792-4834
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2242103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst