MEDICARE: MS. AFSHIN VIRANI NP

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	702908	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	702908	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2007009357	OTHER		AMERICAN NURSES CREDENTIALING CENTER PMHNP CERTIFICATION
2	702908	OTHER	TX	LICENSE

General Provider Information

NPI Number	:	1609059294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AFSHIN VIRANI NP

Provider Business Mailing Address
First Line	:	3901 ARLINGTON HIGHLANDS BLVD
Second Line	:	SUITE 200
City	:	ARLINGTON
State	:	TX
Zip	:	76018-6036
Country	:	US
Telephone Number	:	817-695-5055
Fax Number	:	817-695-5054

Provider Business Practice Location Address
First Line	:	3901 ARLINGTON HIGHLANDS BLVD
Second Line	:	SUITE 200
City	:	ARLINGTON
State	:	TX
Zip	:	76018-6036
Country	:	US
Telephone Number	:	817-695-5055
Fax Number	:	817-695-5054

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

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	07/02/2014

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