MEDICARE: MEGAN DELIBERATO

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	OT015835	PA

General Provider Information

NPI Number	:	1942610308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN DELIBERATO

Provider Business Mailing Address
First Line	:	PO BOX 844658
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-4658
Country	:	US
Telephone Number	:	254-724-8800
Fax Number	:

Provider Business Practice Location Address
First Line	:	9521 W US HIGHWAY 290 STE 105
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78736-7898
Country	:	US
Telephone Number	:	512-654-4300
Fax Number	:

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

Provider Enumeration Date	:	05/06/2014
Last Update Date	:	01/11/2021

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Directions to “ MEGAN DELIBERATO ” Practice Location

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