Organization Name: | SOUTHWEST NEUROLOGY, PA |
NPI Number: | 1467652032 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELIZABETH M MATURE (ADMINISTRATOR) |
Mailing Address: | 6701 Heritage Pkwy Ste 110 Rockwall |
State: | TX US |
Postal Code: | 750878799 |
Phone Number: | 9724128700 |
Fax Number: | 9724129700 |
NPI Enumeration Date: | 07/23/2007 |
NPI Last Update Date: | 09/28/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | J9378 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |