Provider Demographics
NPI:1649525908
Name:PEISER, MEAGAN ANNITTA (PT)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:ANNITTA
Last Name:PEISER
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 1:7001 PARKWOOD BLVD APT 2219
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7166
Mailing Address - Country:US
Mailing Address - Phone:214-679-4059
Mailing Address - Fax:
Practice Address - Street 1:5425 W SPRING CREEK PKWY STE 270
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4317
Practice Address - Country:US
Practice Address - Phone:972-801-2190
Practice Address - Fax:972-801-2191
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1220005225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist