Provider Demographics
NPI:1063675239
Name:STUBINSKI, MEGAN K
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:K
Last Name:STUBINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13615 BELLAIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-1714
Mailing Address - Country:US
Mailing Address - Phone:281-933-3446
Mailing Address - Fax:281-933-6865
Practice Address - Street 1:13615 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-1714
Practice Address - Country:US
Practice Address - Phone:281-933-3446
Practice Address - Fax:281-933-6865
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2009-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7228TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7228TGOtherLICENSE NUMBER
TX8L5425Medicare PIN