Provider Demographics
NPI:1720422884
Name:MADDOX, MEGAN MCCAIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:MCCAIN
Last Name:MADDOX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:DANIELLE
Other - Last Name:MCCAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4191 BELLAIRE BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1017
Mailing Address - Country:US
Mailing Address - Phone:346-356-7000
Mailing Address - Fax:346-356-7001
Practice Address - Street 1:4191 BELLAIRE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1017
Practice Address - Country:US
Practice Address - Phone:346-356-7000
Practice Address - Fax:346-356-7001
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ9190207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX394072801Medicaid