Individual
EMMANUEL ROSARIO NIEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5200 HARRY HINES BLVD, DALLAS, TX 75235-7709
(469) 419-9606
(214) 267-1632
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-0624
(214) 645-0078
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
38060
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38060
LICENSE
TX
Enumeration date
02/26/2019
Last updated
12/21/2021
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