MEDICARE: MEGAN E WARE PT, DPT

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	225100000X	Physical Therapist	1203907	TX

General Provider Information

NPI Number	:	1801194899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN E WARE PT, DPT

Provider Business Mailing Address
First Line	:	3106 S W S YOUNG DR
Second Line	:
City	:	KILLEEN
State	:	TX
Zip	:	76542-2000
Country	:	US
Telephone Number	:	254-628-8391
Fax Number	:	254-628-7821

Provider Business Practice Location Address
First Line	:	3106 S W S YOUNG DR
Second Line	:
City	:	KILLEEN
State	:	TX
Zip	:	76542-2000
Country	:	US
Telephone Number	:	254-628-8391
Fax Number	:	254-628-7821

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

Provider Enumeration Date	:	03/01/2011
Last Update Date	:	03/01/2011

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