Organization
NORTH TEXAS NEUROREHABILITATION CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA MYLES MASINO PSYD (PRESIDENT)
(214) 842-7887
Entity
Organization
Contact information
Practice address
4315 SAN GABRIEL DR, DALLAS, TX 75229-4131
(214) 842-7887
Mailing address
4315 SAN GABRIEL DR, DALLAS, TX 75229-4131
(214) 842-7887
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
34716
TX
Other
Enumeration date
06/05/2014
Last updated
06/05/2014
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