Provider Demographics
NPI:1003949470
Name:HOUSTON, MEAGAN NICOLE (PHD)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:NICOLE
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4606 FM 1960 RD W STE 230
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4617
Mailing Address - Country:US
Mailing Address - Phone:713-854-5654
Mailing Address - Fax:
Practice Address - Street 1:4606 FM 1960 RD W
Practice Address - Street 2:SUITE 407
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4600
Practice Address - Country:US
Practice Address - Phone:713-854-5654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34470103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist