Healthcare Provider Details

I. General information

NPI: 1093365702
Provider Name (Legal Business Name): MEAGAN FREEMAN WHEAT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2019
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 EDWARDS
MERKEL TX
79536-3803
US

IV. Provider business mailing address

217 EDWARDS
MERKEL TX
79536-3803
US

V. Phone/Fax

Practice location:
  • Phone: 325-928-0014
  • Fax: 325-928-1175
Mailing address:
  • Phone: 325-928-0014
  • Fax: 325-928-1189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP143133
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: