Provider Demographics
NPI:1467258079
Name:AVIE, MEGAN ALIS (AGACNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ALIS
Last Name:AVIE
Suffix:
Gender:
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3314 GIBBONS CREST LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-1472
Mailing Address - Country:US
Mailing Address - Phone:337-309-2187
Mailing Address - Fax:
Practice Address - Street 1:18400 KATY FWY STE 570
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1291
Practice Address - Country:US
Practice Address - Phone:832-522-8550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1191465363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care