Organization
NEUROCOGNITIVE SPECIALTY GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUELLA G HERRERA (CREDENTIALING SPECIALIST)
(832) 905-4892
Entity
Organization
Contact information
Practice address
112 MAGNOLIA ESTATES DR, LEAGUE CITY, TX 77573-4613
(888) 606-0086
(346) 223-0296
Mailing address
112 MAGNOLIA ESTATES DR, LEAGUE CITY, TX 77573-4719
(888) 606-0086
(346) 223-0296
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
Other
Enumeration date
03/25/2019
Last updated
05/06/2026
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