MEDICARE: JANA CAMILLE MOPERA

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	367500000X	Certified Registered Nurse Anesthetist	608198	NY
2	367500000X	Certified Registered Nurse Anesthetist	AP128335	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1871985986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA CAMILLE MOPERA

Provider Business Mailing Address
First Line	:	5200 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7709
Country	:	US
Telephone Number	:	469-419-2850
Fax Number	:

Provider Business Practice Location Address
First Line	:	2421 BRIDGETON LN
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-7961
Country	:	US
Telephone Number	:	469-419-2850
Fax Number	:

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

Provider Enumeration Date	:	02/26/2015
Last Update Date	:	10/26/2015

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Directions to “ JANA CAMILLE MOPERA ” Practice Location

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