Provider Demographics
NPI:1982976346
Name:MARTIN, MEGAN ELIZABETH (FNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:MARTIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:BRIDGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2340 E TRINITY MILLS RD STE 250
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-1946
Mailing Address - Country:US
Mailing Address - Phone:972-417-8937
Mailing Address - Fax:
Practice Address - Street 1:1305 AIRPORT FWY STE 405
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6607
Practice Address - Country:US
Practice Address - Phone:855-893-5637
Practice Address - Fax:817-666-3873
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125262208VP0014X, 363LF0000X, 363L00000X
AZ294040363LF0000X
CO0101031363LF0000X
CA21600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1548739964OtherPINNACLE PAIN MEDICINE PLLC
TX401540601Medicaid