Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | M4403 | TX |
N | 2080P0204X | Pediatric Emergency Doctor | M4403 | TX |
NPI | 1033125588 |
---|---|
Provider Name | Megan Malchak Obrien |
First Address | San Antonio, TX 78207-3154 |
Second Address | San Antonio, TX 78207-3108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 19/02/2020 |