MESOBELLA NPI 1689740656

NPI Information

NPI: 1689740656
Provider Name: MESOBELLA
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
731 E SOUTHLAKE BLVD # 180
SOUTHLAKE, TX
ZIP 76092
Phone: (817) 251-6376
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MESOBELLA is a family nurse practitioner in Southlake, TX. MESOBELLA NPI is 1689740656. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

731 E SOUTHLAKE BLVD # 180
SOUTHLAKE, TX
ZIP 76092-377
Phone: (817) 251-6376

The provider's authorized official is Trina Lanza .
The authorized official title is Owner and has the following contact phone number (817) 291-5780.

The enumeration date for this NPI number is 11/28/2006 and was last updated on 1/6/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	583243	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00W172	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	BUSINESS NUMBER
2	Q57338	MEDICARE UPIN	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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