Provider Demographics
NPI:1700218690
Name:KALRA, MEGAN KATHLEEN (AANP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:KATHLEEN
Last Name:KALRA
Suffix:
Gender:F
Credentials:AANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2513 SUNTREE LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-6027
Mailing Address - Country:US
Mailing Address - Phone:801-232-3627
Mailing Address - Fax:
Practice Address - Street 1:977 RAINTREE CIR
Practice Address - Street 2:SUITE 230
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5022
Practice Address - Country:US
Practice Address - Phone:214-383-6611
Practice Address - Fax:214-383-6614
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130338363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1700218690Medicaid
UT1700218690Medicaid