Healthcare Provider Details

I. General information

NPI: 1437859774
Provider Name (Legal Business Name): PRIME NEUROSURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E TAYLOR ST STE 308
SHERMAN TX
75090-2826
US

IV. Provider business mailing address

600 E TAYLOR ST STE 308
SHERMAN TX
75090-2826
US

V. Phone/Fax

Practice location:
  • Phone: 270-227-1679
  • Fax:
Mailing address:
  • Phone: 270-227-1679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ABDUL BAKER
Title or Position: OWNER
Credential: MD
Phone: 270-227-1679