Healthcare Provider Details

I. General information

NPI: 1669668778
Provider Name (Legal Business Name): MEGAN CHRISTY COPELAND OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGAN CHRISTY OTR

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 09/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4510 27TH ST BENDER TERRACE
LUBBOCK TX
79410-1709
US

IV. Provider business mailing address

4510 27TH ST BENDER TERRACE
LUBBOCK TX
79410-1709
US

V. Phone/Fax

Practice location:
  • Phone: 806-785-2464
  • Fax:
Mailing address:
  • Phone: 806-785-2464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number112266
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: