Provider Demographics
NPI:1700587383
Name:COFFEY, MEGHAN (RDN, LD, CDCES)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:COFFEY
Suffix:
Gender:F
Credentials:RDN, LD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 VINTAGE PARK BLVD STE A-670
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-3998
Mailing Address - Country:US
Mailing Address - Phone:860-428-9456
Mailing Address - Fax:
Practice Address - Street 1:134 VINTAGE PARK BLVD STE A-670
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3998
Practice Address - Country:US
Practice Address - Phone:860-428-9456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83444133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered