| V.l.y Neuropsych Group P.a. | |
|
712 N Washington Ave Suite # 411 Dallas TX 75246-1619 | |
| (214) 824-9100 | |
| (214) 824-9101 |
| Full Name | V.l.y Neuropsych Group P.a. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 712 N Washington Ave, Dallas, Texas |
| Authorized Official Name and Position | Vladislav L. Yeganov (OWNER) |
| Authorized Official Contact | 2148249100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| V.l.y Neuropsych Group P.a. 712 N Washington Ave Suite # 411 Dallas TX 75246-1619 Ph: (214) 824-9100 | V.l.y Neuropsych Group P.a. 712 N Washington Ave Suite # 411 Dallas TX 75246-1619 Ph: (214) 824-9100 |
| NPI Number | 1720380009 |
|---|---|
| Provider Enumeration Date | 11/19/2010 |
| Last Update Date | 12/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720380009 | NPI | - | NPPES |
| 166625701 | Medicaid | TX | |
| I08928 | Other | UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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