MEDICARE: MUNA BASNET FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	229447	AZ
2	363LF0000X	Family Nurse Practitioner	824551	NV
3	363LF0000X	Family Nurse Practitioner	AP140383	TX

General Provider Information

NPI Number	:	1306304845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUNA BASNET FNP

Provider Business Mailing Address
First Line	:	12650 N BEACH ST STE 114
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-4245
Country	:	US
Telephone Number	:	682-249-2853
Fax Number	:

Provider Business Practice Location Address
First Line	:	12650 N BEACH ST STE 114
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-4245
Country	:	US
Telephone Number	:	682-249-2853
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2019
Last Update Date	:	03/12/2026

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