MEDICARE: DANA ADELE RACINSKAS 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	363LA2200X	Adult Health Nurse Practitioner	578227	TX

General Provider Information

NPI Number	:	1477574390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA ADELE RACINSKAS NP

Provider Business Mailing Address
First Line	:	7441 MARVIN D LOVE FWY
Second Line	:	300
City	:	DALLAS
State	:	TX
Zip	:	75237-3490
Country	:	US
Telephone Number	:	469-583-3262
Fax Number	:

Provider Business Practice Location Address
First Line	:	7441 MARVIN D LOVE FWY
Second Line	:	300
City	:	DALLAS
State	:	TX
Zip	:	75237-3490
Country	:	US
Telephone Number	:	469-583-3262
Fax Number	:

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

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	10/30/2009

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