Organization
PEDIATRIC NEUROLOGY AND EPILEPSY SPECIALISTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA LICANO (CREDENTIALING MANAGER)
(719) 638-1122
Entity
Organization
Contact information
Practice address
9399 CROWN CREST BLVD STE 350, PARKER, CO 80138-8542
(303) 226-7230
(833) 438-0775
Mailing address
9235 N UNION BLVD STE 150334, COLORADO SPRINGS, CO 80920-7831
(303) 226-7230
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
—
—
Other
Enumeration date
02/03/2026
Last updated
02/03/2026
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