| Dfw Neurology Pllc | |
|
6800 Harris Pkwy Suite 130 Fort Worth TX 76132-4240 | |
| (817) 292-0088 | |
| (855) 285-0906 |
| Full Name | Dfw Neurology Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6800 Harris Pkwy, Fort Worth, Texas |
| Authorized Official Name and Position | Lavanya L Nagineni (SOLE MEMBER) |
| Authorized Official Contact | 8172920088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dfw Neurology Pllc 6800 Harris Pkwy Suite 130 Fort Worth TX 76132-4240 Ph: (817) 292-0088 | Dfw Neurology Pllc 6800 Harris Pkwy Suite 130 Fort Worth TX 76132-4240 Ph: (817) 292-0088 |
| NPI Number | 1194978478 |
|---|---|
| Provider Enumeration Date | 10/30/2008 |
| Last Update Date | 12/13/2022 |
| Certification Date | 12/13/2022 |
| Medicare PECOS PAC ID | 8527123991 |
|---|---|
| Medicare Enrollment ID | O20090218000517 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194978478 | NPI | - | NPPES |
| 201059701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | M9524 (Texas) | Primary |
| 2085N0700X | Radiology - Neuroradiology | (* (Not Available)) | Secondary |
| Provider Name | Lavanya Nagineni |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699986943 PECOS PAC ID: 1254495690 Enrollment ID: I20090203000278 |
| Provider Name | Maria Audrie Dejesus |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336176387 PECOS PAC ID: 3072553486 Enrollment ID: I20130227000373 |
| Provider Name | Princy Varghese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578983052 PECOS PAC ID: 4789806589 Enrollment ID: I20141111002137 |
| Provider Name | Shailesh C Vora |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902878473 PECOS PAC ID: 2860479805 Enrollment ID: I20150113001501 |
| Provider Name | Nirav Chandrakant Shah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588982664 PECOS PAC ID: 0345488185 Enrollment ID: I20150808015727 |
| Provider Name | Asha Daniella Inniss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730634742 PECOS PAC ID: 0941555197 Enrollment ID: I20180612002562 |
| Provider Name | Fatoumata Sakho |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851737985 PECOS PAC ID: 6305142530 Enrollment ID: I20180620000244 |
| Provider Name | Stephanie A Johnsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639710403 PECOS PAC ID: 0446682637 Enrollment ID: I20191108000487 |
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