Provider Demographics
NPI:1205212842
Name:GEURDS, MEGAN
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:GEURDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5249 US HIGHWAY 277 S
Mailing Address - Street 2:APT 236
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-4594
Mailing Address - Country:US
Mailing Address - Phone:518-937-4296
Mailing Address - Fax:
Practice Address - Street 1:1718 PINE ST
Practice Address - Street 2:SUITE 2600A
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-3044
Practice Address - Country:US
Practice Address - Phone:325-676-7948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56820183500000X
NY060470183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist