Healthcare Provider Details

I. General information

NPI: 1013433358
Provider Name (Legal Business Name): RED RIVER NEUROSURGICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2017
Last Update Date: 08/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E TAYLOR ST STE 304
SHERMAN TX
75090-2880
US

IV. Provider business mailing address

2516 PROVINE RD
MCKINNEY TX
75070-3938
US

V. Phone/Fax

Practice location:
  • Phone: 903-814-1558
  • Fax: 903-957-1018
Mailing address:
  • Phone: 903-814-1558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberN1605
License Number StateTX

VIII. Authorized Official

Name: DR. MARK VIKTOR SILVER
Title or Position: OWNER
Credential: MD
Phone: 903-814-1558