Provider Demographics
NPI:1457901027
Name:PITANIELLO, MERI PATRICIA
Entity Type:Individual
Prefix:
First Name:MERI
Middle Name:PATRICIA
Last Name:PITANIELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 N CENTRAL EXPY STE 215
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0929
Mailing Address - Country:US
Mailing Address - Phone:469-231-5085
Mailing Address - Fax:469-217-7062
Practice Address - Street 1:8210 WALNUT HILL LN STE 312
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4419
Practice Address - Country:US
Practice Address - Phone:214-238-3074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142467363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner