MEDICARE: DR. MEGAN LEBEAU SWONKE MD

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	207YS0123X	Facial Plastic Surgery Physician	V8410	TX
2	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	04-49484	KS
3	207Y00000X	Otolaryngology Physician	BP10067749	TX

General Provider Information

NPI Number	:	1336704121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGAN LEBEAU SWONKE MD

Provider Business Mailing Address
First Line	:	2813 W T C JESTER BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-7004
Country	:	US
Telephone Number	:	713-496-2427
Fax Number	:

Provider Business Practice Location Address
First Line	:	2813 W T C JESTER BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-7004
Country	:	US
Telephone Number	:	713-496-2427
Fax Number	:

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

Provider Enumeration Date	:	05/07/2019
Last Update Date	:	04/06/2026

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