| Brownsville Neurology Neurophysiology Clinic | |
|
4770 N Expressway Suite 100 Brownsville TX 78526-4120 | |
| (956) 550-9020 | |
| (956) 550-9050 |
| Full Name | Brownsville Neurology Neurophysiology Clinic |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4770 N Expressway, Brownsville, Texas |
| Authorized Official Name and Position | Luis E Gaitan (PRESIDENT) |
| Authorized Official Contact | 9565509020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brownsville Neurology Neurophysiology Clinic Po Box 676786 Dallas TX 75267-6786 Ph: (956) 550-9020 | Brownsville Neurology Neurophysiology Clinic 4770 N Expressway Suite 100 Brownsville TX 78526-4120 Ph: (956) 550-9020 |
| NPI Number | 1205885837 |
|---|---|
| Provider Enumeration Date | 05/10/2006 |
| Last Update Date | 05/12/2022 |
| Certification Date | 05/12/2022 |
| Medicare PECOS PAC ID | 0648262295 |
|---|---|
| Medicare Enrollment ID | O20040401001499 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205885837 | NPI | - | NPPES |
| DA4272 | Other | TX | GROUP # MEDICARE RAILROAD |
| 0043KH | Other | TX | BCBS NUMBER |
| 139289100 | Other | TX | VALLEY BAPTIST HEALTH PLA |
| 159853401 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | K1442 (Texas) | Primary |
| Provider Name | Luis E Gaitan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275605974 PECOS PAC ID: 6406848050 Enrollment ID: I20040428000932 |
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