Mesquite Neurology Clinic PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

K3984 Issued in TX

Legal business name

MESQUITE NEUROLOGY CLINIC PA

Practice address

1320 N Galloway Ave Ste 101
Mesquite, TX 75149-2461

Phone

(972) 329-9001

Fax

(972) 279-9040

NPI assigned

Dec 19, 2006

Last updated

Mar 30, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lutfi Basatneh, M.D.NPI 1881620581

Title

Physician

Phone

(972) 329-9001

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lutfi Basatneh, M.D.

  • Specialist
  • Mesquite, TX
  • NPI 1881620581
  Medicare reassignment NPD Authorized official
• Ali Jafarian, D.O.

  • Family Medicine Physician
  • Mesquite, TX
  • NPI 1033127873
  NPD (past)
• Ahmad Sabouni, M.D.

  • Neurology Physician
  • Lubbock, TX
  • NPI 1124199187
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1063575942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2698 N GALLOWAY AVE",
            "address_2": "SUITE 102",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506383",
            "telephone_number": "972-329-9001",
            "fax_number": "972-279-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 N GALLOWAY AVE STE 101",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492461",
            "telephone_number": "972-329-9001",
            "fax_number": "972-279-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESQUITE NEUROLOGY CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "BASATNEH",
        "authorized_official_first_name": "LUTFI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "972-329-9001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K3984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "00X189",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1881620581",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GRUOP NUMBER",
            "identifier": "1063575942",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mesquite Injury Rehab
• Mesquite Internal Medicine
• Mesquite Medical & Surgical Clinic P.a.
• Mesquite Medical Clinic
• Mesquite Medical Group, LLC (PA Housecalls)
• Mesquite Nursing Center, L.P. (Mesquite Tree Nursing Center)
• Mesquite Pharmacy LLC (Mesquite Pharmacy)
• Mesquite Pharmacy RX LLC (Mesquite Pharmacy)
• Mesquite Pharmacy RX LLC (Mesquite Pharmacy)
• Mesquite Pharmacy RX LLC

• Specialist in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.