MEDICARE: ADVANCED NEUROLOGICAL SERVICES OF DALLAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)	64282001	TX

General Provider Information

NPI Number	:	1275536526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED NEUROLOGICAL SERVICES OF DALLAS

Provider Business Mailing Address
First Line	:	13619 INWOOD RD
Second Line	:	STE 325
City	:	DALLAS
State	:	TX
Zip	:	75244-4643
Country	:	US
Telephone Number	:	972-386-4375
Fax Number	:	972-386-0451

Provider Business Practice Location Address
First Line	:	13619 INWOOD RD
Second Line	:	STE 325
City	:	DALLAS
State	:	TX
Zip	:	75244-4643
Country	:	US
Telephone Number	:	972-386-4375
Fax Number	:	972-386-0451

Authorized Official
Title or Position	:	DRO
Name	:	BELINDA MCBAIN
Credential	:
Telephone Number	:	817-292-2208

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	08/22/2020

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