Provider Demographics
NPI:1831442623
Name:RIVAS, MEAGAN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:RIVAS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:17200 HWY 249
Mailing Address - Street 2:170
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17200 HWY 249
Practice Address - Street 2:170
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064
Practice Address - Country:US
Practice Address - Phone:713-252-9962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105214235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist