Provider Demographics
NPI:1407872039
Name:MEGNA, ROBERT J (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:MEGNA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:FERRIS
Mailing Address - State:TX
Mailing Address - Zip Code:75125-2021
Mailing Address - Country:US
Mailing Address - Phone:972-842-3016
Mailing Address - Fax:972-842-3940
Practice Address - Street 1:207 W 5TH ST
Practice Address - Street 2:
Practice Address - City:FERRIS
Practice Address - State:TX
Practice Address - Zip Code:75125-2021
Practice Address - Country:US
Practice Address - Phone:972-842-3016
Practice Address - Fax:972-842-3940
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1516207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0998171-01Medicaid
TX0998171-01Medicaid
TX00QK89Medicare PIN