Provider Demographics
NPI:1609513936
Name:POWERS, MEGAN CHRISTINE (LAT)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:CHRISTINE
Last Name:POWERS
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:CHRISTINE
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:411 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1713
Mailing Address - Country:US
Mailing Address - Phone:214-820-9533
Mailing Address - Fax:717-635-3104
Practice Address - Street 1:2948 MISTYS RUN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6833
Practice Address - Country:US
Practice Address - Phone:817-455-6958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer