Provider Demographics
NPI:1396014205
Name:CONRAD, MEGAN L (RD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:L
Last Name:CONRAD
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Gender:F
Credentials:RD
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Mailing Address - Street 1:1601 RIO GRANDE ST
Mailing Address - Street 2:SUITE 340
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1137
Mailing Address - Country:US
Mailing Address - Phone:512-324-8960
Mailing Address - Fax:512-324-8962
Practice Address - Street 1:1301 W 38TH ST
Practice Address - Street 2:SUITE 514
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1000
Practice Address - Country:US
Practice Address - Phone:512-681-0500
Practice Address - Fax:512-681-0501
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
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Provider Licenses
StateLicense IDTaxonomies
TXDT80892133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered