Provider Demographics
NPI:1467935916
Name:REX, MEAGAN ASHLEY (PTA)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:ASHLEY
Last Name:REX
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-3514
Mailing Address - Country:US
Mailing Address - Phone:214-906-7363
Mailing Address - Fax:
Practice Address - Street 1:101 REESE DR
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-2376
Practice Address - Country:US
Practice Address - Phone:469-552-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2123142225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant