1134405244 NPI number — MRS. MEAGAN DUBEAU MARKSBURY LPC

Table of content: MRS. MEAGAN DUBEAU MARKSBURY LPC (NPI 1134405244)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134405244 NPI number — MRS. MEAGAN DUBEAU MARKSBURY LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARKSBURY
Provider First Name:
MEAGAN
Provider Middle Name:
DUBEAU
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUBEAU
Provider Other First Name:
MEAGAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134405244
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1276 BELLINGHAM DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OCEANSIDE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92057-2723
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-433-2913
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 AYERS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78404-1917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-882-9010
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  63228 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com