Provider Demographics
NPI:1205533296
Name:CARTER, MEAGAN BOURQUE (PT, DPT, OCS)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:BOURQUE
Last Name:CARTER
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2512 W PECAN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-1033
Mailing Address - Country:US
Mailing Address - Phone:512-240-2204
Mailing Address - Fax:512-337-2442
Practice Address - Street 1:2512 W PECAN ST STE 100
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-1033
Practice Address - Country:US
Practice Address - Phone:512-240-2204
Practice Address - Fax:512-337-2442
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1372394225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist