Healthcare Provider Details

I. General information

NPI: 1669947131
Provider Name (Legal Business Name): NEUROCONNECT CLINICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2018
Last Update Date: 10/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 SUGAR CREEK CENTER BLVD STE 510
SUGAR LAND TX
77478-3673
US

IV. Provider business mailing address

77 SUGAR CREEK CENTER BLVD STE 510
SUGAR LAND TX
77478-3673
US

V. Phone/Fax

Practice location:
  • Phone: 713-234-7422
  • Fax:
Mailing address:
  • Phone: 713-234-7422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: CLARIAN CARRINGTON
Title or Position: ADMINISTRATOR
Credential:
Phone: 832-532-0863