Provider Demographics
NPI:1265121107
Name:MARKWARDT, MEGHANA BRAJESH (DPT)
Entity type:Individual
Prefix:
First Name:MEGHANA
Middle Name:BRAJESH
Last Name:MARKWARDT
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:MEGHANA
Other - Middle Name:BRAJESH
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 2650
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-8607
Mailing Address - Country:US
Mailing Address - Phone:972-724-2400
Mailing Address - Fax:972-724-2495
Practice Address - Street 1:3001 FM 2181 STE 150
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210-0109
Practice Address - Country:US
Practice Address - Phone:940-498-4004
Practice Address - Fax:940-498-4008
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1383054225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist