| Neurophysiology | |
|
6116 N Central Expy Suite 1000 Dallas TX 75206-5162 | |
| (214) 738-4961 | |
| Not Available |
| Full Name | Neurophysiology |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6116 N Central Expy, Dallas, Texas |
| Authorized Official Name and Position | Nolan Bruce Jenevein (PRESIDENT) |
| Authorized Official Contact | 2147384961 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurophysiology 8122 San Fernando Way Dallas TX 75218-4434 Ph: (214) 738-4961 | Neurophysiology 6116 N Central Expy Suite 1000 Dallas TX 75206-5162 Ph: (214) 738-4961 |
| NPI Number | 1760700330 |
|---|---|
| Provider Enumeration Date | 05/06/2010 |
| Last Update Date | 06/10/2010 |
| Medicare PECOS PAC ID | 2062545684 |
|---|---|
| Medicare Enrollment ID | O20100803001120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760700330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | H2492 (Texas) | Primary |
| Provider Name | Nicole A Simpkins |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396940532 PECOS PAC ID: 0042360570 Enrollment ID: I20090604000172 |
| Provider Name | Nolan B Jenevein |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346217163 PECOS PAC ID: 0143356253 Enrollment ID: I20100329000341 |
| Provider Name | Jennifer L Donnelly Straach |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1386821270 PECOS PAC ID: 8224152947 Enrollment ID: I20100902000372 |
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