| Neurocenter Texas Pa | |
|
7701 Las Colinas Rdg Ste 260 Irving TX 75063-7554 | |
| (972) 869-3448 | |
| (469) 372-5307 |
| Full Name | Neurocenter Texas Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7701 Las Colinas Rdg Ste 260, Irving, Texas |
| Authorized Official Name and Position | Tisha E Bailleu (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 2142392078 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurocenter Texas Pa 7701 Las Colinas Ridge Suite 260 Irving TX 75063-7554 Ph: (972) 869-3448 | Neurocenter Texas Pa 7701 Las Colinas Rdg Ste 260 Irving TX 75063-7554 Ph: (972) 869-3448 |
| NPI Number | 1477870954 |
|---|---|
| Provider Enumeration Date | 04/23/2010 |
| Last Update Date | 07/12/2019 |
| Medicare PECOS PAC ID | 2163555426 |
|---|---|
| Medicare Enrollment ID | O20100806000460 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477870954 | NPI | - | NPPES |
| 1477870954 | Other | TX | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | J2296 (Texas) | Primary |
| Provider Name | Thomas H Salmon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124124110 PECOS PAC ID: 4789647355 Enrollment ID: I20041105000199 |
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