Provider Demographics
NPI:1336362060
Name:NEUROTHERAPY CENTER OF PLANO, INC
Entity type:Organization
Organization Name:NEUROTHERAPY CENTER OF PLANO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:GRAY
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-612-9787
Mailing Address - Street 1:2317 COIT RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-3774
Mailing Address - Country:US
Mailing Address - Phone:972-612-9787
Mailing Address - Fax:972-964-6968
Practice Address - Street 1:2317 COIT RD
Practice Address - Street 2:SUITE C
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3774
Practice Address - Country:US
Practice Address - Phone:972-612-9787
Practice Address - Fax:972-964-6968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22090101Y00000X, 101YM0800X, 103T00000X, 103TA0400X, 103TA0700X, 103TB0200X, 103TC0700X, 103TC1900X, 103TC2200X, 103TF0000X, 103TH0004X, 103TH0100X, 103TR0400X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
Not Answered103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Multi-Specialty
Not Answered103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4130480OtherAETNA PROVIDER #
TXPHD22090OtherMAGELLAN ID #
TX194918OtherVALUE OPTIONS PROVIDER #
TX2141362OtherCIGNA PROVIDER #
TX82GROtherBCBS GROUP #
TX4130480OtherAETNA PROVIDER #
TX00976TMedicare ID - Type UnspecifiedMEDICARE GROUP #