Integris Neuro Group Llc | |
1800 Buckner St Ste B200 Shreveport LA 71101-4440 | |
(972) 998-1548 | |
(877) 492-1768 |
Full Name | Integris Neuro Group Llc |
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Speciality | Psychiatry & Neurology |
Location | 1800 Buckner St Ste B200, Shreveport, Louisiana |
Authorized Official Name and Position | Steven Estes (PRESIDENT/CEO) |
Authorized Official Contact | 8779442111 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Integris Neuro Group Llc 2012 Justin Rd Ste 200a Highland Village TX 75077-7151 Ph: (972) 998-1548 | Integris Neuro Group Llc 1800 Buckner St Ste B200 Shreveport LA 71101-4440 Ph: (972) 998-1548 |
NPI Number | 1174391593 |
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Provider Enumeration Date | 12/14/2023 |
Last Update Date | 12/14/2023 |
Certification Date | 12/14/2023 |
Medicare PECOS PAC ID | 8921426800 |
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Medicare Enrollment ID | O20240202001526 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174391593 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
Provider Name | Rachna Patel |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1144647264 PECOS PAC ID: 1153650643 Enrollment ID: I20240202001694 |
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