Provider Demographics
NPI:1356960934
Name:SOUDERS, MORGAN MCKENNA LEEANN
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:MCKENNA LEEANN
Last Name:SOUDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MCKENNA
Other - Middle Name:LEEANN
Other - Last Name:SOUDERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:317 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2005
Mailing Address - Country:US
Mailing Address - Phone:281-732-9258
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN ST STE 21
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:832-826-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120678225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist