Organization
NEUROCENTER TEXAS PA
Active
Organization
NEUROCENTER TEXAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TISHA E BAILLEU (PRACTICE ADMINISTRATOR)
(214) 239-2078
Entity
Organization
Contact information
Practice address
7701 LAS COLINAS RDG STE 260, IRVING, TX 75063-7554
(972) 869-3448
(469) 372-5307
Mailing address
7701 LAS COLINAS RIDGE, SUITE 260, IRVING, TX 75063-7554
(972) 869-3448
(469) 372-5307
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
J2296
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477870954
NPI
TX
Enumeration date
04/23/2010
Last updated
07/12/2019
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