| Medical Neurology | |
|
2300 Highway 365 Ste 600 Nederland TX 77627-6258 | |
| (409) 983-2711 | |
| (409) 853-1641 |
| Full Name | Medical Neurology |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2300 Highway 365 Ste 600, Nederland, Texas |
| Authorized Official Name and Position | Emem D Udonta (ADMINISTRATOR) |
| Authorized Official Contact | 4099832711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Neurology 2300 Highway 365 Ste 600 Nederland TX 77627-6258 Ph: (409) 983-2711 | Medical Neurology 2300 Highway 365 Ste 600 Nederland TX 77627-6258 Ph: (409) 983-2711 |
| NPI Number | 1982828604 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 05/26/2020 |
| Certification Date | 05/26/2020 |
| Medicare PECOS PAC ID | 2466409362 |
|---|---|
| Medicare Enrollment ID | O20050404000150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982828604 | NPI | - | NPPES |
| 130004816 | Other | TX | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Elias M Ntsoane |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720263874 PECOS PAC ID: 7113067042 Enrollment ID: I20091228000143 |
| Provider Name | Emem Dan Udonta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851377675 PECOS PAC ID: 2860532991 Enrollment ID: I20100907000542 |
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