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NPI Code Detail

MEDICARE: MRS. MEGAN PELLACANI-RICHEY PT, DPT

MEDICARE: MRS. MEGAN PELLACANI-RICHEY PT, DPT
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
1225100000XPhysical Therapist1345626TX

General Provider Information

NPI Number : 1790359651
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MEGAN PELLACANI-RICHEY PT, DPT
Provider Business Mailing Address
First Line : 405 ALLENCREST DR
Second Line :
City : WHITE SETTLEMENT
State : TX
Zip : 76108-2741
Country : US
Telephone Number : 512-992-7173
Fax Number :
Provider Business Practice Location Address
First Line : 1000 BONNIE BRAE AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76111-4355
Country : US
Telephone Number : 682-235-3816
Fax Number : 817-887-2719
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2021
Last Update Date : 05/16/2021

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