| Lewisville Neurology P.a. | |
|
3120 Medpark Dr Ste 100 Denton TX 76208-6982 | |
| (940) 383-1770 | |
| (940) 566-2214 |
| Full Name | Lewisville Neurology P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3120 Medpark Dr Ste 100, Denton, Texas |
| Authorized Official Name and Position | Judy K Camp (OFFICE MANAGER) |
| Authorized Official Contact | 9403831776 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewisville Neurology P.a. 3120 Medpark Dr Ste 100 Denton TX 76208-6982 Ph: (940) 383-1770 | Lewisville Neurology P.a. 3120 Medpark Dr Ste 100 Denton TX 76208-6982 Ph: (940) 383-1770 |
| NPI Number | 1982825683 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 01/17/2024 |
| Certification Date | 01/17/2024 |
| Medicare PECOS PAC ID | 2961651229 |
|---|---|
| Medicare Enrollment ID | O20121001000308 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982825683 | NPI | - | NPPES |
| 335788103 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Lynn Wang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912929605 PECOS PAC ID: 4981665999 Enrollment ID: I20041022000887 |
| Provider Name | Jayaraman Ravindran |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497719348 PECOS PAC ID: 0042272049 Enrollment ID: I20041102000358 |
| Provider Name | Eric Christian Drew |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578539839 PECOS PAC ID: 1951341122 Enrollment ID: I20050506000265 |
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