| Neurointerp, Pllc | |
|
4025 Stanford Ave Dallas TX 75225-7006 | |
| (121) 453-6164 | |
| (214) 536-1647 |
| Full Name | Neurointerp, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 4025 Stanford Ave, Dallas, Texas |
| Authorized Official Name and Position | Nolan Bruce Jenevein (PRESIDENT) |
| Authorized Official Contact | 2147384961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurointerp, Pllc 5600 W Lovers Ln Ste 116-133 Dallas TX 75209-4330 Ph: (214) 536-1647 | Neurointerp, Pllc 4025 Stanford Ave Dallas TX 75225-7006 Ph: (121) 453-6164 |
| NPI Number | 1730605940 |
|---|---|
| Provider Enumeration Date | 08/18/2017 |
| Last Update Date | 08/18/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730605940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | H2492 (Texas) | Primary |
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