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1578773511

NPI Code Detail

MEDICARE: DR. CRISTI LYNN AITELLI D.O.

MEDICARE: DR. CRISTI LYNN AITELLI D.O.

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	207R00000X	Internal Medicine Physician	N1521	TX
2	207R00000X	Internal Medicine Physician	158695	MT
3	207RX0202X	Medical Oncology Physician	158695	MT
4	207RX0202X	Medical Oncology Physician	N1521	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00831393	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578773511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRISTI LYNN AITELLI D.O.

Provider Business Mailing Address
First Line	:	PO BOX 911230
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-1230
Country	:	US
Telephone Number	:	972-997-8000
Fax Number	:	972-234-2987

Provider Business Practice Location Address
First Line	:	6500 HARRIS PKWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4136
Country	:	US
Telephone Number	:	817-346-6748
Fax Number	:	817-263-2615

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	04/30/2025

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Directions to “ DR. CRISTI LYNN AITELLI D.O.” Practice Location

Language	Start Address	Practice Location

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