Provider Demographics
NPI:1134938616
Name:LEWIS, MEGAN (RBT CPR)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:X
Credentials:RBT CPR
Other - Prefix:
Other - First Name:FRED
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:24124 CINCO VILLAGE CENTER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-8389
Mailing Address - Country:US
Mailing Address - Phone:832-263-6593
Mailing Address - Fax:
Practice Address - Street 1:24124 CINCO VILLAGE CENTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-8389
Practice Address - Country:US
Practice Address - Phone:832-263-6593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-24-365202106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician