MEDICARE: MR. DWIGHT EDWIN MORGAN M.A., LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	02483	TX

General Provider Information

NPI Number	:	1205845450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DWIGHT EDWIN MORGAN M.A., LPC

Provider Business Mailing Address
First Line	:	1401 HIGHWAY 360
Second Line	:	# 1333
City	:	EULESS
State	:	TX
Zip	:	76039-5234
Country	:	US
Telephone Number	:	214-542-9092
Fax Number	:	817-282-0331

Provider Business Practice Location Address
First Line	:	1600 AIRPORT FWY
Second Line	:	STE. 320
City	:	BEDFORD
State	:	TX
Zip	:	76022-6850
Country	:	US
Telephone Number	:	214-542-9092
Fax Number	:	817-282-0331

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/08/2007

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