Provider Demographics
NPI:1639222896
Name:BELL, MEGAN ELIZABETH (PT)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:BELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 ROWLAND PL APT A
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-1701
Mailing Address - Country:US
Mailing Address - Phone:832-567-4168
Mailing Address - Fax:
Practice Address - Street 1:3206 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5143
Practice Address - Country:US
Practice Address - Phone:903-753-6635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1171400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist