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General NPI Number Information
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NPI Number | 1124809199
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE NEUROLOGY CENTER, PA
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Dates
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Enumeration Date | 10/06/2023
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 1600 COIT RD STE 406
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City | PLANO
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State | TX
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Zip | 75075-6173
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Country | US
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Telephone | 469-977-1010
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Fax | 469-977-1155
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Provider Business Mailing Address
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Address Line | 1600 COIT RD STE 406
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City | PLANO
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State | TX
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Zip | 75075-6173
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Country | US
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Telephone | 469-977-1010
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Fax | 469-977-1155
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUPRIYA THIRUNARAYANAN
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Credential | MD
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Telephone | 469-977-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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