Individual provider Active NPI

Maegen Breann Bunch, PTA

  • Physical Medicine & Rehabilitation Physician
  • Houston, TX
National Provider Identifier
1699404616
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2150272 Issued in TX
Practice address
11120 North Fwy
Houston, TX 77037-1029
Phone
(281) 875-1800
NPI assigned
Jun 6, 2022
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2150272 TX Primary

Addresses

Primary practice location

11120 North Fwy
Houston, TX 77037-1029

Mailing address

11120 North Fwy
Houston, TX 77037-1029

Other practice location 1

1150 N Loop 336 w
Conroe, TX 77301-1156
Phone (936) 494-3777

Other practice location 2

8717 Humble Westfield Rd Bldg h
Humble, TX 77338-4471
Phone (281) 548-2772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2150272TXMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1699404616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 NORTH FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770371029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 NORTH FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770371029",
            "telephone_number": "281-875-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 N Loop 336 w",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773011156",
            "country_code": "US",
            "telephone_number": "936-494-3777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8717 Humble Westfield Rd Bldg h",
            "address_purpose": "LOCATION",
            "city": "Humble",
            "state": "TX",
            "postal_code": "773384471",
            "country_code": "US",
            "telephone_number": "281-548-2772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNCH",
        "first_name": "MAEGEN",
        "middle_name": "BREANN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "2150272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.