Healthcare Provider Details

I. General information

NPI: 1841022415
Provider Name (Legal Business Name): MEGAN MCKNIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 PATE ORR RD S
KELLER TX
76248-1400
US

IV. Provider business mailing address

800 HEMPHILL ST
FORT WORTH TX
76104-3107
US

V. Phone/Fax

Practice location:
  • Phone: 817-337-0162
  • Fax:
Mailing address:
  • Phone: 817-338-4220
  • Fax: 817-338-1639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1397382
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: