| Neurometrics, Pllc | |
|
7146 S Braden Ave Ste 500 Tulsa OK 74136-6376 | |
| (210) 309-5124 | |
| Not Available |
| Full Name | Neurometrics, Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 7146 S Braden Ave Ste 500, Tulsa, Oklahoma |
| Authorized Official Name and Position | Russell D Pella (OWNER) |
| Authorized Official Contact | 2103095124 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurometrics, Pllc 5213 S Vandalia Ave Apt 4g Tulsa OK 74135-4038 Ph: (210) 309-5124 | Neurometrics, Pllc 7146 S Braden Ave Ste 500 Tulsa OK 74136-6376 Ph: (210) 309-5124 |
| NPI Number | 1457711251 |
|---|---|
| Provider Enumeration Date | 03/07/2016 |
| Last Update Date | 03/07/2016 |
| Medicare PECOS PAC ID | 3173822897 |
|---|---|
| Medicare Enrollment ID | O20160502002289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457711251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 1248 (Oklahoma) | Primary |
| Provider Name | Russell Pella |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700177391 PECOS PAC ID: 5698946622 Enrollment ID: I20160209001868 |
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