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General NPI Number Information
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NPI Number | 1043910631
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Entity Type | Organization
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Legal Business Name | MESA SPRINGS PHYSICIAN GROUP LLC
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Dates
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Enumeration Date | 03/03/2023
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 4935 S COLLINS ST
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City | ARLINGTON
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State | TX
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Zip | 76018-1191
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Country | US
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Telephone | 682-273-4194
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Fax |
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Provider Business Mailing Address
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Address Line | 330 SEVEN SPRINGS WAY
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City | BRENTWOOD
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State | TN
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Zip | 37027-5098
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Country | US
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Telephone | 412-588-3546
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Fax | 615-920-8775
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Authorized Official
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Title or Position | ENROLLMENT SPECIALIST
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Name | NICOLE KENDRA
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Credential |
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Telephone | 412-588-3546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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