Individual provider Active NPI

Nathalie Alejandra Reza Haro, CPNP-PC

  • Primary Care Nurse Practitioner
  • Prosper, TX
National Provider Identifier
1255103263
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1112069 Issued in TX
Practice address
4100 W University Dr
Prosper, TX 75078-3123
Phone
(945) 204-4100
Fax
(682) 885-1903
NPI assigned
Oct 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1112069 TX Primary
Pediatric Nurse Practitioner 363LP0200X 1112069 TX

Addresses

Primary practice location

4100 W University Dr
Prosper, TX 75078-3123

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nreza2087741@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240208002803 TX Practitioner - Nurse Practitioner 4587007380 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1112069TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nreza2087741@cookchildrens.direct-ci.com
  • Direct secure messaging: nreza208741@cookchildrens.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1255103263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W UNIVERSITY DR",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783123",
            "telephone_number": "945-204-4100",
            "fax_number": "682-885-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZA HARO",
        "first_name": "NATHALIE",
        "middle_name": "ALEJANDRA",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1112069",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1112069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nreza2087741@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "4100 W University Dr",
            "city": "Prosper",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750783123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.