Provider Demographics
NPI:1063982080
Name:INTERNATIONAL CENTER FOR NEUROSCIENCE
Entity type:Organization
Organization Name:INTERNATIONAL CENTER FOR NEUROSCIENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-969-8988
Mailing Address - Street 1:4141 SOUTHWEST FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7387
Mailing Address - Country:US
Mailing Address - Phone:832-932-9300
Mailing Address - Fax:855-790-3974
Practice Address - Street 1:4141 SOUTHWEST FWY STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7387
Practice Address - Country:US
Practice Address - Phone:832-932-9300
Practice Address - Fax:855-790-3974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty