Provider Demographics
NPI:1548727316
Name:MEEGADA, SWAPNA (PT)
Entity type:Individual
Prefix:
First Name:SWAPNA
Middle Name:
Last Name:MEEGADA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 701837
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75370-1837
Mailing Address - Country:US
Mailing Address - Phone:214-483-3170
Mailing Address - Fax:214-377-4244
Practice Address - Street 1:14683 MIDWAY RD STE 160
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3188
Practice Address - Country:US
Practice Address - Phone:214-483-3170
Practice Address - Fax:214-377-4244
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1310088225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1310088OtherTEXAS BOARD OF PHYSICAL THERAPY EXAMINERS