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General NPI Number Information
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NPI Number | 1700368727
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Entity Type | Individual
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Provider Name | MEGAN JAYNE BORIGO PTA
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Gender | Female
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Dates
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Enumeration Date | 09/06/2018
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | 19333 US-59 SUITE 230
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City | HUMBLE
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State | TX
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Zip | 77338
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Country | US
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Telephone | 281-548-2772
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Fax |
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Provider Business Mailing Address
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Address Line | 2443 FM 1488 RD APT 2431
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City | CONROE
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State | TX
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Zip | 77384-4932
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Country | US
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Telephone | 717-676-5818
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2137439
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License Number State | TX
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