MEDICARE: MEAGAN KAY WILSON OTR

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	225X00000X	Occupational Therapist	121261	TX

General Provider Information

NPI Number	:	1386396273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEAGAN KAY WILSON OTR

Provider Business Mailing Address
First Line	:	5706 VALLEY RIDGE CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-1136
Country	:	US
Telephone Number	:	682-472-7375
Fax Number	:

Provider Business Practice Location Address
First Line	:	4011 BENBROOK HWY STE C
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-7800
Country	:	US
Telephone Number	:	817-386-5500
Fax Number	:

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

Provider Enumeration Date	:	01/21/2022
Last Update Date	:	01/21/2022

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Directions to “ MEAGAN KAY WILSON OTR” Practice Location

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