Basic Information
| Provider Information | |||||||||
| NPI: | 1932645702 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DIDONATO | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | ATC LAT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ONEY | ||||||||
| OtherFirstName: | MEGAN | ||||||||
| OtherMiddleName: | S | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | ATC LAT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6767 LAKE WOODLANDS DR | ||||||||
| Address2: | SUITE F | ||||||||
| City: | THE WOODLANDS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773822566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813641122 | ||||||||
| FaxNumber: | 2812102446 | ||||||||
| Practice Location | |||||||||
| Address1: | 6767 LAKE WOODLANDS DR | ||||||||
| Address2: | SUITE F | ||||||||
| City: | THE WOODLANDS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773822566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813641122 | ||||||||
| FaxNumber: | 2812102446 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2017 | ||||||||
| LastUpdateDate: | 01/17/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | AT4357 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.