MEDICARE: MRS. MONA ELTIAR APRN, FNP

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	363LF0000X	Family Nurse Practitioner	AP131405	TX

General Provider Information

NPI Number	:	1518414341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MONA ELTIAR APRN, FNP

Provider Business Mailing Address
First Line	:	9509 N BEACH ST STE 102
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-6399
Country	:	US
Telephone Number	:	817-617-8600
Fax Number	:	877-906-1852

Provider Business Practice Location Address
First Line	:	9509 N BEACH ST STE 102
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-6399
Country	:	US
Telephone Number	:	817-617-8600
Fax Number	:	877-906-1852

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

Provider Enumeration Date	:	09/09/2016
Last Update Date	:	02/20/2026

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