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General NPI Number Information
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NPI Number | 1417383233
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Entity Type | Organization
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Legal Business Name | NEUROLOGY ASSOCIATES OF METROPLEX, P.A.
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Dates
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Enumeration Date | 09/25/2013
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 1600 W COLLEGE ST SUITE LL40
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City | GRAPEVINE
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State | TX
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Zip | 76051-3580
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Country | US
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Telephone | 817-865-6281
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Fax | 817-865-6287
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Provider Business Mailing Address
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Address Line | 1600 W COLLEGE ST SUITE LL40
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City | GRAPEVINE
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State | TX
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Zip | 76051-3580
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Country | US
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Telephone | 817-865-6281
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Fax | 817-865-6287
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Authorized Official
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Title or Position | PRESIDENT
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Name | MADHURI L KOGANTI
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Credential | MD
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Telephone | 817-865-6281
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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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