MEDICARE: MEAGAN NICOLE HOUSTON PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	34470	TX

General Provider Information

NPI Number	:	1003949470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEAGAN NICOLE HOUSTON PH.D.

Provider Business Mailing Address
First Line	:	4606 FM 1960 RD W STE 230
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-4617
Country	:	US
Telephone Number	:	713-854-5654
Fax Number	:

Provider Business Practice Location Address
First Line	:	4606 FM 1960 RD W
Second Line	:	SUITE 407
City	:	HOUSTON
State	:	TX
Zip	:	77069-4600
Country	:	US
Telephone Number	:	713-854-5654
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	06/29/2021

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