Basic Information
| Provider Information | |||||||||
| NPI: | 1851862296 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAVIS | ||||||||
| FirstName: | MAEGAN | ||||||||
| MiddleName: | |||||||||
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| Credential: | RD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2450 HOLCOMBE BLVD STE NB34L | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770212039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8328283660 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8611 N MOPAC EXPY STE 300 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787598319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7372208200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2018 | ||||||||
| LastUpdateDate: | 03/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | DT84399 | TX | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.