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222 W Las Colinas Blvd Suite 1650 Irving TX 75039 | |
| (972) 501-1452 | |
| (972) 401-4091 |
| Full Name | |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 222 W Las Colinas Blvd, Irving, Texas |
| Authorized Official Name and Position | Richard S Cowles (DIRECTOR CEO) |
| Authorized Official Contact | 9725011452 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
222 W Las Colinas Blvd Suite 1650 Irving TX 75039 Ph: (972) 501-1452 | 222 W Las Colinas Blvd Suite 1650 Irving TX 75039 Ph: (972) 501-1452 |
| NPI Number | 1841458254 |
|---|---|
| Provider Enumeration Date | 06/02/2008 |
| Last Update Date | 06/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841458254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 33276 (Texas) | Primary |
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