Provider Demographics
NPI:1518576834
Name:WHITE, MEGAN ALEXANDRA (OD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ALEXANDRA
Last Name:WHITE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:ALEXANDRA
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1109 ROCK PRAIRIE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-8651
Mailing Address - Country:US
Mailing Address - Phone:979-764-0669
Mailing Address - Fax:855-325-7670
Practice Address - Street 1:1109 ROCK PRAIRIE RD STE 300
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8651
Practice Address - Country:US
Practice Address - Phone:979-764-0669
Practice Address - Fax:855-325-7670
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10026T152W00000X
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program