Provider Demographics
NPI: | 1285053058 |
---|---|
Name: | TMS CENTER OF LEXINGTON, PLLC |
Entity type: | Organization |
Organization Name: | TMS CENTER OF LEXINGTON, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | COO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | EFRAIN |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | MIRANDA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 859-455-6715 |
Mailing Address - Street 1: | 9378 S MASON MONTGOMERY RD STE 102 |
Mailing Address - Street 2: | |
Mailing Address - City: | MASON |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 45040-8827 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 859-455-6715 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1000 MONARCH ST STE 280 |
Practice Address - Street 2: | |
Practice Address - City: | LEXINGTON |
Practice Address - State: | KY |
Practice Address - Zip Code: | 40513-1494 |
Practice Address - Country: | US |
Practice Address - Phone: | 859-455-6715 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | CLINICAL ANATOMY ASSOCIATES, INC. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2014-04-09 |
Last Update Date: | 2016-12-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Single Specialty |