Provider Demographics
NPI:1386870996
Name:NEUROPSYCHOLOGY ASSOCIATES OF NORTH TEXAS
Entity type:Organization
Organization Name:NEUROPSYCHOLOGY ASSOCIATES OF NORTH TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-251-0911
Mailing Address - Street 1:1340 N WHITE CHAPEL BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-4322
Mailing Address - Country:US
Mailing Address - Phone:817-251-0911
Mailing Address - Fax:817-416-2731
Practice Address - Street 1:1340 N WHITE CHAPEL BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-4322
Practice Address - Country:US
Practice Address - Phone:817-251-0911
Practice Address - Fax:817-416-2731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3-0853103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty