Healthcare Provider Details

I. General information

NPI: 1629782420
Provider Name (Legal Business Name): MEGAN POTTMEYER APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2023
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14700 FM 2100 RD STE A
CROSBY TX
77532-9161
US

IV. Provider business mailing address

14700 FM 2100 RD STE A
CROSBY TX
77532-9161
US

V. Phone/Fax

Practice location:
  • Phone: 281-328-2568
  • Fax: 281-328-2039
Mailing address:
  • Phone: 281-328-2568
  • Fax: 281-328-2039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1011046
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: