Healthcare Provider Details

I. General information

NPI: 1780850537
Provider Name (Legal Business Name): ELITE NEURO SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8409 PICKWICK LN # 175
DALLAS TX
75225-5323
US

IV. Provider business mailing address

PO BOX 678211
DALLAS TX
75267-8211
US

V. Phone/Fax

Practice location:
  • Phone: 214-317-4666
  • Fax: 214-317-4667
Mailing address:
  • Phone: 214-317-4666
  • Fax: 214-317-4667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name: PAUL SCHULMAN
Title or Position: MANAGER
Credential:
Phone: 214-317-4666