| Texas Movement Disorder Specialists Pllc | |
|
204 S Interstate 35 Ste 103 Georgetown TX 78628-4125 | |
| (512) 693-4041 | |
| (512) 290-9226 |
| Full Name | Texas Movement Disorder Specialists Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 204 S Interstate 35 Ste 103, Georgetown, Texas |
| Authorized Official Name and Position | Michael Soileau (OWNER) |
| Authorized Official Contact | 5126934041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Movement Disorder Specialists Pllc 204 S Interstate 35 Ste 103 Georgetown TX 78628-4125 Ph: (512) 693-4041 | Texas Movement Disorder Specialists Pllc 204 S Interstate 35 Ste 103 Georgetown TX 78628-4125 Ph: (512) 693-4041 |
| NPI Number | 1902337025 |
|---|---|
| Provider Enumeration Date | 03/21/2017 |
| Last Update Date | 06/18/2020 |
| Certification Date | 06/18/2020 |
| Medicare PECOS PAC ID | 7214214501 |
|---|---|
| Medicare Enrollment ID | O20170516001377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902337025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | P5005 (Texas) | Primary |
| Provider Name | Michael Soileau |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922237817 PECOS PAC ID: 4688899644 Enrollment ID: I20140707001307 |
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