Healthcare Provider Details

I. General information

NPI: 1790695906
Provider Name (Legal Business Name): CORTEX MIGRAINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13901 E EXPOSITION AVE STE 100
AURORA CO
80012-2536
US

IV. Provider business mailing address

1500 N GRANT ST STE C
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 253-777-2237
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DENNIS OLIVER WANG
Title or Position: OWNER
Credential: MD
Phone: 253-777-2237