Provider Demographics
NPI:1104055342
Name:NEURODIAGNOSTIC CENTER OF TEXAS ASSOCIATES P A
Entity type:Organization
Organization Name:NEURODIAGNOSTIC CENTER OF TEXAS ASSOCIATES P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-276-3320
Mailing Address - Street 1:PO BOX 703324
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75370-3324
Mailing Address - Country:US
Mailing Address - Phone:940-389-7664
Mailing Address - Fax:
Practice Address - Street 1:7920 PRESTON RD
Practice Address - Street 2:STE 600
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2343
Practice Address - Country:US
Practice Address - Phone:866-620-5987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8958207R00000X
TXD26222084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty