Provider Demographics
NPI:1851610307
Name:KILDOW, MEGAN RENEE (PHARMD, BCACP, CDE)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:RENEE
Last Name:KILDOW
Suffix:
Gender:F
Credentials:PHARMD, BCACP, CDE
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:RENEE
Other - Last Name:STAPLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, BCACP, CDE
Mailing Address - Street 1:4500 S LANCASTER RD
Mailing Address - Street 2:BLDG 7
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7167
Mailing Address - Country:US
Mailing Address - Phone:214-372-5300
Mailing Address - Fax:
Practice Address - Street 1:4500 S LANCASTER RD
Practice Address - Street 2:BLDG 7
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7167
Practice Address - Country:US
Practice Address - Phone:214-372-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000331751835P1200X
TX494371835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy