| North Texas Neurological Associates | |
|
1050 N Beltline Ste 103 Mesquite TX 75149 | |
| (972) 288-1038 | |
| (972) 288-1418 |
| Full Name | North Texas Neurological Associates |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1050 N Beltline, Mesquite, Texas |
| Authorized Official Name and Position | Daryoush Kaboli (OWNER) |
| Authorized Official Contact | 9722881038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Texas Neurological Associates 1050 N Beltline Ste 103 Mesquite TX 75149 Ph: (972) 288-1039 | North Texas Neurological Associates 1050 N Beltline Ste 103 Mesquite TX 75149 Ph: (972) 288-1038 |
| NPI Number | 1073521027 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2365488459 |
|---|---|
| Medicare Enrollment ID | O20050629000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073521027 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | E8605 (Texas) | Primary |
| Provider Name | Randi H Baculi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801854914 PECOS PAC ID: 8729076435 Enrollment ID: I20040503000777 |
| Provider Name | Jai Kumar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730271768 PECOS PAC ID: 1052327962 Enrollment ID: I20060302000134 |
| Provider Name | Zakaria Siddiq |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326083072 PECOS PAC ID: 8628071107 Enrollment ID: I20060823000373 |
| Provider Name | Venkatesh Nagaraddi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447381728 PECOS PAC ID: 2163510355 Enrollment ID: I20071126000235 |
| Provider Name | Sharisse Stephenson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538358684 PECOS PAC ID: 6709071087 Enrollment ID: I20101111001455 |
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