| Compass Neurology | |
|
1301 Doctors Dr Tyler TX 75701-2239 | |
| (903) 405-2880 | |
| (903) 405-1881 |
| Full Name | Compass Neurology |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1301 Doctors Dr, Tyler, Texas |
| Authorized Official Name and Position | Allison Hennigan (PROVIDER) |
| Authorized Official Contact | 7195053822 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compass Neurology 1403 Brandywine Dr Tyler TX 75703-5705 Ph: (719) 505-3822 | Compass Neurology 1301 Doctors Dr Tyler TX 75701-2239 Ph: (903) 405-2880 |
| NPI Number | 1962997148 |
|---|---|
| Provider Enumeration Date | 06/28/2018 |
| Last Update Date | 06/28/2018 |
| Medicare PECOS PAC ID | 5698021772 |
|---|---|
| Medicare Enrollment ID | O20180703000251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962997148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Allison L Hennigan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730335829 PECOS PAC ID: 2062545536 Enrollment ID: I20100804000553 |
| Provider Name | Katy Sutton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356996573 PECOS PAC ID: 2163857905 Enrollment ID: I20200124000233 |
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