Provider Demographics
NPI:1841783024
Name:POINDEXTER, MEAGAN BREE
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:BREE
Last Name:POINDEXTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SANDY LN
Mailing Address - Street 2:
Mailing Address - City:GLADEWATER
Mailing Address - State:TX
Mailing Address - Zip Code:75647-5640
Mailing Address - Country:US
Mailing Address - Phone:903-431-3326
Mailing Address - Fax:
Practice Address - Street 1:204 SANDY LN
Practice Address - Street 2:
Practice Address - City:GLADEWATER
Practice Address - State:TX
Practice Address - Zip Code:75647-5640
Practice Address - Country:US
Practice Address - Phone:903-431-3326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX384971303747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant