Provider Demographics
NPI:1376598730
Name:MEGWA, JOSEPH M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:MEGWA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:614 MATLOCK CENTRE CIR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2536
Mailing Address - Country:US
Mailing Address - Phone:817-548-9092
Mailing Address - Fax:817-548-9092
Practice Address - Street 1:614 MATLOCK CENTRE CIR
Practice Address - Street 2:FAMILY PRACTICE
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2536
Practice Address - Country:US
Practice Address - Phone:817-548-9092
Practice Address - Fax:817-548-9092
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0176207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H87339Medicare UPIN
TX8F2689Medicare PIN
TX00W346Medicare PIN