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General NPI Number Information
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NPI Number | 1598700106
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Entity Type | Organization
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Legal Business Name | NEUROVAS TREATMENT CENTERS
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 603 MATLOCK CENTRE CIR
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City | ARLINGTON
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State | TX
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Zip | 76015-2535
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Country | US
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Telephone | 817-795-5470
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Fax | 817-795-5472
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Provider Business Mailing Address
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Address Line | 5000 QUAIL CREEK DR
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City | MCKINNEY
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State | TX
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Zip | 75070-5310
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Country | US
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Telephone | 972-529-1008
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Fax | 972-540-1344
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL MELTON
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Credential |
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Telephone | 972-529-1008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | E1245
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License Number State | TX
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