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General NPI Number Information
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NPI Number | 1134463599
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Entity Type | Organization
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Legal Business Name | NEUROSCIENCE RESOURCES PLLC
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Dates
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Enumeration Date | 11/24/2012
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 1400 GEORGE DIETER DR STE 100
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City | EL PASO
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State | TX
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Zip | 79936-7654
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Country | US
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Telephone | 915-247-3150
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Fax | 915-703-3745
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Provider Business Mailing Address
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Address Line | 1400 GEORGE DIETER DR STE 100
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City | EL PASO
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State | TX
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Zip | 79936-7654
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Country | US
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Telephone | 915-247-3150
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Fax | 915-703-3745
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Authorized Official
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Title or Position | GOVERNING AUTHORITY
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Name | DR. BRATISLAV VELIMIROVIC
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Credential | M.D., PH.D.
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Telephone | 917-549-7710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | P4000
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | P4000
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | P4000
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License Number State | TX
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