Basic Information
| Provider Information | |||||||||
| NPI: | 1063147973 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MESZKO | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | JOSEPH | ||||||||
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| Credential: | RN, SRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4009 DOGWOOD LN | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761371715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124265505 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2710 S RIFE MEDICAL LN | ||||||||
| Address2: | |||||||||
| City: | ROGERS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727581452 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4793388000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2022 | ||||||||
| LastUpdateDate: | 07/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 23257034 | MO | Y | Nursing Service Providers | Registered Nurse |
No ID Information.