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General NPI Number Information
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NPI Number | 1124438072
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Entity Type | Individual
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Provider Name | NESTOR ARITA MD
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Gender | Male
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 628 HOSPITAL DR
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-2953
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Country | US
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Telephone | 508-320-0708
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Fax |
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Provider Business Mailing Address
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Address Line | 1 BAYLOR PLZ 404D
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City | HOUSTON
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State | TX
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Zip | 77030-3411
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | BP10050138
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 63127
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | E-17695
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License Number State | AR
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