Organization
MESQUITE NEUROLOGY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUTFI BASATNEH M.D. (PHYSICIAN)
(972) 329-9001
Entity
Organization
Contact information
Practice address
1320 N GALLOWAY AVE STE 101, MESQUITE, TX 75149-2461
(972) 329-9001
(972) 279-9040
Mailing address
2698 N GALLOWAY AVE, SUITE 102, MESQUITE, TX 75150-6383
(972) 329-9001
(972) 279-9040
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
K3984
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00X189
MEDICARE GROUP NUMBER
TX
01
—
1063575942
NPI GRUOP NUMBER
TX
01
—
1881620581
NPI
TX
Enumeration date
12/19/2006
Last updated
03/30/2021
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