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General NPI Number Information
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NPI Number | 1619458403
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Entity Type | Organization
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Legal Business Name | NEUROPRO OF TEXAS
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 12412 JUDSON RD
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City | LIVE OAK
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State | TX
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Zip | 78233-3255
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Country | US
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Telephone | 210-331-7266
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Fax |
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Provider Business Mailing Address
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Address Line | 11703 HUEBNER RD STE 106-402
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City | SAN ANTONIO
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State | TX
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Zip | 78230-1201
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Country | US
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Telephone | 210-331-7266
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | ALLEN GARCIA
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Credential |
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Telephone | 210-445-5079
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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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