Provider Demographics
NPI:1316695505
Name:WHIDDON, MEGAN E (PT, DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:WHIDDON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:E
Other - Last Name:PURSWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7005 WOODWAY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6160
Mailing Address - Country:US
Mailing Address - Phone:254-224-8062
Mailing Address - Fax:
Practice Address - Street 1:7005 WOODWAY DR STE 101
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-6160
Practice Address - Country:US
Practice Address - Phone:254-224-8062
Practice Address - Fax:254-224-6385
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1301727225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist