Basic Information
Provider Information
NPI: 1598938193
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARCIA
FirstName: MEGAN
MiddleName: LOUISE
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 736 SW ESTATES DRIVE
Address2:  
City: LEES SUMMIT
State: MO
PostalCode: 64082
CountryCode: US
TelephoneNumber: 5052648917
FaxNumber:  
Practice Location
Address1: 10730 NALL AVE
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662111366
CountryCode: US
TelephoneNumber: 9137542800
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/04/2008
LastUpdateDate: 03/28/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X0436591KSY Allopathic & Osteopathic PhysiciansSurgery 
208600000X2013021789MON Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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