Healthcare Provider Details

I. General information

NPI: 1063335172
Provider Name (Legal Business Name): PREMIER NEUROLOGY OF TEXAS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 W PROSPER TRL STE 720
PROSPER TX
75078-4357
US

IV. Provider business mailing address

4260 WHITLEY PLACE DR
PROSPER TX
75078-9005
US

V. Phone/Fax

Practice location:
  • Phone: 469-327-2460
  • Fax: 833-468-5158
Mailing address:
  • Phone: 682-559-1956
  • 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: AMANDA SKELTON
Title or Position: OWNER & NURSE PRACTITIONER
Credential: APRN-CNP
Phone: 682-559-1956