Healthcare Provider Details

I. General information

NPI: 1689127516
Provider Name (Legal Business Name): MEGAN THOMAS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 07/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 CHAMPIONS PLAZA DR SUITE 400
HOUSTON TX
77069-2396
US

IV. Provider business mailing address

7010 CHAMPIONS PLAZA DR SUITE 400
HOUSTON TX
77069-2396
US

V. Phone/Fax

Practice location:
  • Phone: 281-880-9180
  • Fax:
Mailing address:
  • Phone: 281-880-9180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number903331
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: