Healthcare Provider Details

I. General information

NPI: 1669470092
Provider Name (Legal Business Name): TEXOMA NEUROLOGY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2005
Last Update Date: 11/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N HIGHLAND AVE STE 200
SHERMAN TX
75092
US

IV. Provider business mailing address

321 N HIGHLAND AVE STE 200
SHERMAN TX
75092
US

V. Phone/Fax

Practice location:
  • Phone: 903-893-5141
  • Fax: 903-891-4285
Mailing address:
  • Phone: 903-893-5141
  • Fax: 903-891-4285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberH5637
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateTX

VIII. Authorized Official

Name: DEBRA PRICE
Title or Position: BILLING MANAGER
Credential:
Phone: 903-893-5141