Provider Demographics
NPI:1124330998
Name:EUBANK, MEGAN (AUD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:EUBANK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11797 SOUTH FWY
Mailing Address - Street 2:STE 132
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7026
Mailing Address - Country:US
Mailing Address - Phone:817-551-0466
Mailing Address - Fax:
Practice Address - Street 1:11797 SOUTH FWY
Practice Address - Street 2:STE 132
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7026
Practice Address - Country:US
Practice Address - Phone:817-551-0466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80226231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist