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Individual

MISS MEGHAN WILLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
140 UPTOWN AVE, BROWNSVILLE, TX 78520-7559
(956) 544-7722
(956) 544-7728
Mailing address
140 UPTOWN AVE, BROWNSVILLE, TX 78520-7559
(956) 544-7722
(956) 544-7728

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1199902
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
169033101
TX
01
45-4849
MEDICARE
TX
Enumeration date
10/13/2010
Last updated
10/13/2010
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