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General NPI Number Information
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NPI Number | 1326234782
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Entity Type | Individual
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Provider Name | DAVID M. EGAN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 03/10/2009
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Provider Practice Location Address
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Address Line | 12314 W 73RD TER
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City | SHAWNEE
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State | KS
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Zip | 66216-3673
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Country | US
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Telephone | 913-558-3519
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Fax | 913-499-0781
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Provider Business Mailing Address
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Address Line | 12314 W 73RD TER
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City | SHAWNEE
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State | KS
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Zip | 66216-3673
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Country | US
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Telephone | 913-558-3519
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Fax | 913-499-0781
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | R0259
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | R0259
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License Number State | MO
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