Basic Information
Provider Information
NPI: 1366807349
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KOBEL
FirstName: MEGAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: AU.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5303 HARRY HINES BLVD
Address2: SUITE 106
City: DALLAS
State: TX
PostalCode: 753908868
CountryCode: US
TelephoneNumber: 5026415123
FaxNumber:  
Practice Location
Address1: 5303 HARRY HINES BLVD
Address2: SUITE 106
City: DALLAS
State: TX
PostalCode: 753908868
CountryCode: US
TelephoneNumber: 2146458898
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/17/2015
LastUpdateDate: 12/17/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XA.01934OHY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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