MEDICARE: DEVON KNEISEL

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	363L00000X	Nurse Practitioner	1017794	TX

General Provider Information

NPI Number	:	1033977145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVON KNEISEL

Provider Business Mailing Address
First Line	:	PO BOX 35629
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-0629
Country	:	US
Telephone Number	:	214-424-2200
Fax Number	:	214-231-2159

Provider Business Practice Location Address
First Line	:	7835 BOULEVARD 26
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-7105
Country	:	US
Telephone Number	:	817-589-1822
Fax Number	:	817-595-4597

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

Provider Enumeration Date	:	03/12/2024
Last Update Date	:	08/06/2025

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Directions to “ DEVON KNEISEL ” Practice Location

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