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NPI Code Detail

MEDICARE: MR. HOSS MANSOORI FNP-C

MEDICARE: MR. HOSS MANSOORI FNP-C
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
1111NI0900XInternist Chiropractor10190TX
2363LF0000XFamily Nurse PractitionerAP130793TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1814012460OTHERTXTAX ID

General Provider Information

NPI Number : 1952416323
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. HOSS MANSOORI FNP-C
Provider Business Mailing Address
First Line : 3100 INDEPENDENCE PKWY
Second Line :
City : PLANO
State : TX
Zip : 75075-9152
Country : US
Telephone Number : 214-553-5543
Fax Number : 214-553-5531
Provider Business Practice Location Address
First Line : 3100 INDEPENDENCE PKWY
Second Line :
City : PLANO
State : TX
Zip : 75075-9152
Country : US
Telephone Number : 214-553-5543
Fax Number : 214-553-5531
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 03/01/2018

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