MEDICARE: JESSE OPELA

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	985320	TX

General Provider Information

NPI Number	:	1336945948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSE OPELA

Provider Business Mailing Address
First Line	:	201 SAINT JOSEPH CT STE 320
Second Line	:
City	:	LIBERTY HILL
State	:	TX
Zip	:	78642-3404
Country	:	US
Telephone Number	:	512-277-0676
Fax Number	:	737-250-7650

Provider Business Practice Location Address
First Line	:	201 SAINT JOSEPH CT STE 320
Second Line	:
City	:	LIBERTY HILL
State	:	TX
Zip	:	78642-3404
Country	:	US
Telephone Number	:	512-277-0676
Fax Number	:	737-250-7650

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

Provider Enumeration Date	:	02/24/2025
Last Update Date	:	02/24/2025

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Directions to “ JESSE OPELA ” Practice Location

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