Organization
PEDINEURO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIE J NEVILLE OT (ADMINISTRATOR)
(512) 917-0642
Entity
Organization
Contact information
Practice address
3403 NEEDLES DR, AUSTIN, TX 78746-1410
(412) 920-4000
Mailing address
3403 NEEDLES DR, AUSTIN, TX 78746-1410
(412) 920-4000
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
G2405
TX
Other
Enumeration date
01/27/2015
Last updated
01/27/2015
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