Provider Demographics
NPI:1003324732
Name:BURGART, MEAGAN (BCABA)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:BURGART
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4924 DUKE DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-4079
Mailing Address - Country:US
Mailing Address - Phone:254-913-8204
Mailing Address - Fax:
Practice Address - Street 1:504 W JASPER DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-1312
Practice Address - Country:US
Practice Address - Phone:254-716-8743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4197103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty