is a Neurological Surgery in Southlake, Texas. practices all healthcare services and medical treatments related to Neurological Surgery. The NPI Number for is 1144487174. The last update date is .
's current location address is 1110 E State Highway 114, Southlake, Texas. You can contact this provider via phone number 8175027411 and fax number 8175027412. The mailing address for is 1110 E State Highway 114, Southlake, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1110 E State Highway 114, Southlake, Texas |
| Phone Number | 8175027411 |
| Fax Number | 8175027412 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1144487174 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1110 E State Highway 114 |
|---|---|
| City | Southlake |
| State | Texas (TX) |
| Post Code | 760925251 |
| Phone Number | 8175027411 |
| Fax Number | 8175027412 |
Provider's Primary Taxonomy Detail
| Speciality | Neurological Surgery |
|---|---|
| Taxonomy | 207T00000X |
| Licence No | P9148 |
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Definition: A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 341503601 | TX | -- | |
| 8EM652 | TX | BCBS |
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