Healthcare Provider Details

I. General information

NPI: 1982984001
Provider Name (Legal Business Name): NORTH CENTRAL TEXAS ADVANCED NEUROLOGY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2011
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 SFM 51 SUITE 100
DECATUR TX
76234-3778
US

IV. Provider business mailing address

2351 SFM 51 SUITE 100
DECATUR TX
76234-3778
US

V. Phone/Fax

Practice location:
  • Phone: 940-626-8634
  • Fax: 940-626-8637
Mailing address:
  • Phone: 940-626-8634
  • Fax: 940-626-8637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: MUHAMMAD NAEEM
Title or Position: OWNER M.D
Credential: M.D.
Phone: 940-626-8634