Provider Demographics
NPI:1689035198
Name:PECKIS, MEGHAN LAURIE (RD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LAURIE
Last Name:PECKIS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 SAVOY DR
Mailing Address - Street 2:SUITE 540
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3300
Mailing Address - Country:US
Mailing Address - Phone:713-778-1300
Mailing Address - Fax:713-778-0827
Practice Address - Street 1:6800 WEST LOOP S
Practice Address - Street 2:SUITE 560
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4528
Practice Address - Country:US
Practice Address - Phone:713-839-7111
Practice Address - Fax:713-839-7156
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82178133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic