Provider Demographics
NPI:1275829491
Name:COKER, MEGAN ELIZABETH (MS, CFY)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:COKER
Suffix:
Gender:F
Credentials:MS, CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 LEMMON AVE APT 307
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2343
Mailing Address - Country:US
Mailing Address - Phone:832-876-7812
Mailing Address - Fax:
Practice Address - Street 1:3117 LEMMON AVE APT 307
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2343
Practice Address - Country:US
Practice Address - Phone:832-876-7812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75-1282040Medicaid