Provider Demographics
NPI:1679858484
Name:COREAS, MEAGHAN MARIE (PT)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:MARIE
Last Name:COREAS
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 1:7602 STONE ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-7550
Mailing Address - Country:US
Mailing Address - Phone:281-408-6646
Mailing Address - Fax:
Practice Address - Street 1:7602 STONE ARBOR LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-7550
Practice Address - Country:US
Practice Address - Phone:281-408-6646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11658682251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics