Organization
MRS NEUROSURGICAL CLINIC
Active
Other names
Chang Neurosurgery and Spinecare
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA K HERRON (BILLING DIRECTOR)
(214) 778-2530
Entity
Organization
Contact information
Practice address
4001 W 15TH ST, SUITE 260, PLANO, TX 75093-5841
(214) 778-2530
(214) 778-2542
Mailing address
PO BOX 262449, PLANO, TX 75026-2449
(214) 778-2530
(214) 778-2542
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H3003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039SQ
BLUE CROSS GROUP PROVIDER NUMBER
TX
01
—
1023240751
GROUP NPI
TX
01
—
1659364412
INDIVIDUAL NPI
TX
05
—
285096801
—
TX
Enumeration date
08/13/2009
Last updated
01/22/2012
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