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General NPI Number Information
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NPI Number | 1376074435
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Entity Type | Individual
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Provider Name | MEGAN ELIZABETH LIBERTY D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 1500 COOPER ST
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City | FORT WORTH
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State | TX
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Zip | 76104-2710
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Country | US
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Telephone | 682-885-4405
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Fax | 682-885-4407
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Provider Business Mailing Address
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Address Line | PO BOX 733784
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City | DALLAS
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State | TX
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Zip | 75373-3784
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Country | US
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Telephone | 682-885-6483
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Fax | 682-885-3113
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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 | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number | 34014437
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number | V9498
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License Number State | TX
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