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General NPI Number Information
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NPI Number | 1407723554
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Entity Type | Organization
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Legal Business Name | NEUROGLOW P.C.
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 4961 LONG PRAIRIE RD
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City | FLOWER MOUND
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State | TX
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Zip | 75028-2793
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Country | US
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Telephone | 800-975-3859
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Fax |
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Provider Business Mailing Address
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Address Line | 4961 LONG PRAIRIE RD
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City | FLOWER MOUND
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State | TX
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Zip | 75028-2793
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Country | US
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Telephone | 800-975-3859
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MOMIN ZAFARULLAH
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Credential | CRNA
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Telephone | 210-862-4199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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