Provider Demographics
NPI:1093348237
Name:BARRY, MEAGAN LEE (PA-C)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:LEE
Last Name:BARRY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:515 W MAYFIELD RD STE 104
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2083
Mailing Address - Country:US
Mailing Address - Phone:877-314-8990
Mailing Address - Fax:833-794-3342
Practice Address - Street 1:810 N ZANG BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4263
Practice Address - Country:US
Practice Address - Phone:214-941-4243
Practice Address - Fax:214-941-1153
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
TXPA13591363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant