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General NPI Number Information
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NPI Number | 1104277730
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Entity Type | Organization
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Legal Business Name | TEXAS INSTITUTE FOR NEUROSCIENCES
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Dates
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Enumeration Date | 06/24/2016
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Last Update Date | 06/24/2016
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Provider Practice Location Address
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Address Line | 5425 W SPRING CREEK PKWY SUITE 270
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City | PLANO
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State | TX
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Zip | 75024-4236
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Country | US
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Telephone | 214-361-6092
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Fax | 214-481-4556
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Provider Business Mailing Address
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Address Line | PO BOX 2160
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City | BOULDER
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State | CO
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Zip | 80306-2160
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Country | US
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Telephone | 214-361-6092
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Fax | 214-481-4556
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LYNSEY COOPER
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Credential |
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Telephone | 214-361-6092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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