Provider Demographics
NPI:1619335122
Name:DAULTON, MEGHAN JOHNSON (NP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:JOHNSON
Last Name:DAULTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 PINECROFT DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3279
Mailing Address - Country:US
Mailing Address - Phone:281-419-8400
Mailing Address - Fax:281-292-1972
Practice Address - Street 1:9200 PINECROFT DR
Practice Address - Street 2:SUITE 250
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3279
Practice Address - Country:US
Practice Address - Phone:281-419-8400
Practice Address - Fax:281-292-1972
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130146363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health