Provider Demographics
NPI:1154533982
Name:NEUROSCIENCE ASSOCIATES OF TEXAS, P.A.
Entity type:Organization
Organization Name:NEUROSCIENCE ASSOCIATES OF TEXAS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:ESCOBAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:281-668-5598
Mailing Address - Street 1:6606 FM 1488 RD
Mailing Address - Street 2:SUITE 148-494
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-2544
Mailing Address - Country:US
Mailing Address - Phone:281-668-5598
Mailing Address - Fax:281-789-7722
Practice Address - Street 1:710 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3402
Practice Address - Country:US
Practice Address - Phone:281-668-5598
Practice Address - Fax:281-789-7722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ64232084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079903301Medicaid
TX00109RMedicare ID - Type UnspecifiedGROUP ID