Healthcare Provider Details

I. General information

NPI: 1275767899
Provider Name (Legal Business Name): MEGAN BECKER POWELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1169 GRAND CENTRAL PKWY
CONROE TX
77304-3185
US

IV. Provider business mailing address

1169 GRAND CENTRAL PKWY
CONROE TX
77304-3185
US

V. Phone/Fax

Practice location:
  • Phone: 936-525-3600
  • Fax:
Mailing address:
  • Phone: 936-525-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP5300
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP5300
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: