MEDICARE: MEGAN MILES SELLARS FNP

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	207Q00000X	Family Medicine Physician	1033252	TX

General Provider Information

NPI Number	:	1912570714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MILES SELLARS FNP

Provider Business Mailing Address
First Line	:	12171 W PARMER LN STE 102
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-7362
Country	:	US
Telephone Number	:	512-537-2177
Fax Number	:	512-572-1277

Provider Business Practice Location Address
First Line	:	12171 W PARMER LN STE 102
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-7362
Country	:	US
Telephone Number	:	512-537-2177
Fax Number	:	512-572-1277

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

Provider Enumeration Date	:	07/20/2021
Last Update Date	:	07/07/2023

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