Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP129856 | TX |
NPI | 1184096703 |
---|---|
Provider Name | Meghan Surley |
First Address | Flower Mound, TX 75028-2158 |
Second Address | Flower Mound, TX 75028-2158 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2015 |
Last Update Date | 30/03/2016 |