Provider Demographics
NPI:1205533296
Name:CARTER, MEAGAN BOURQUE
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:BOURQUE
Last Name:CARTER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 LYNDON FARM CT STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5005
Mailing Address - Country:US
Mailing Address - Phone:726-202-3039
Mailing Address - Fax:210-978-5592
Practice Address - Street 1:15803 WINDERMERE DR STE 204
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2485
Practice Address - Country:US
Practice Address - Phone:512-647-1720
Practice Address - Fax:512-647-1722
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist