MEDICARE: FELISTUS NYATICHI MOTARI

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	164X00000X	Licensed Vocational Nurse	344958	TX

General Provider Information

NPI Number	:	1598230278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELISTUS NYATICHI MOTARI

Provider Business Mailing Address
First Line	:	6610 BERYL DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-5466
Country	:	US
Telephone Number	:	816-298-1156
Fax Number	:

Provider Business Practice Location Address
First Line	:	6610 BERYL DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-5466
Country	:	US
Telephone Number	:	817-298-1156
Fax Number	:

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

Provider Enumeration Date	:	10/09/2018
Last Update Date	:	10/09/2018

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Directions to “ FELISTUS NYATICHI MOTARI ” Practice Location

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