MEDICARE: MRS. MEGAN HALE

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	225700000X	Massage Therapist	120077	TX

General Provider Information

NPI Number	:	1568825537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEGAN HALE

Provider Business Mailing Address
First Line	:	5307 W HIGHWAY 290 STE 2
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78735-8960
Country	:	US
Telephone Number	:	512-903-7655
Fax Number	:

Provider Business Practice Location Address
First Line	:	5307 W HIGHWAY 290 STE 2
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78735-8960
Country	:	US
Telephone Number	:	512-903-7655
Fax Number	:

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

Provider Enumeration Date	:	03/29/2016
Last Update Date	:	03/29/2016

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Directions to “ MRS. MEGAN HALE ” Practice Location

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