Healthcare Provider Details

I. General information

NPI: 1427964329
Provider Name (Legal Business Name): MEGAN ANNE BEASLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W STATE HIGHWAY 114 STE 100
GRAPEVINE TX
76051-8648
US

IV. Provider business mailing address

8390 NAVISOTA DR STE 100
LANTANA TX
76226-7343
US

V. Phone/Fax

Practice location:
  • Phone: 214-867-6600
  • Fax: 214-867-6601
Mailing address:
  • Phone: 214-867-6600
  • Fax: 214-867-6601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number106482
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: