| Neurodiagnostic Center Pa | |
|
107 Medical Park Dr Lufkin TX 75904-3135 | |
| (936) 634-6333 | |
| (936) 634-6337 |
| Full Name | Neurodiagnostic Center Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 107 Medical Park Dr, Lufkin, Texas |
| Authorized Official Name and Position | Sunil Cherry (OWNER/PRESIDENT) |
| Authorized Official Contact | 9366346333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurodiagnostic Center Pa 107 Medical Park Dr Lufkin TX 75904-3135 Ph: (936) 634-6333 | Neurodiagnostic Center Pa 107 Medical Park Dr Lufkin TX 75904-3135 Ph: (936) 634-6333 |
| NPI Number | 1164087748 |
|---|---|
| Provider Enumeration Date | 05/08/2019 |
| Last Update Date | 05/08/2019 |
| Medicare PECOS PAC ID | 2062849649 |
|---|---|
| Medicare Enrollment ID | O20200220000099 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164087748 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Sunil Cherry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659559763 PECOS PAC ID: 5395934954 Enrollment ID: I20110722000523 |
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