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General NPI Number Information
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NPI Number | 1730633249
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Entity Type | Organization
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Legal Business Name | NECK DISC REPLACEMENT, PLLC
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 05/26/2018
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Provider Practice Location Address
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Address Line | 2222 GREENHOUSE RD STE 1100A
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City | HOUSTON
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State | TX
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Zip | 77084
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Country | US
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Telephone | 913-515-9814
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Fax | 832-288-5967
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Provider Business Mailing Address
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Address Line | PO BOX 19437
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City | HOUSTON
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State | TX
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Zip | 77224-9437
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Country | US
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Telephone | 281-529-6626
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Fax | 832-288-5967
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Authorized Official
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Title or Position | NEUROSURGEON
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Name | BARAA AL-HAFEZ
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Credential | MD
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Telephone | 913-515-9814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | P6764
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License Number State | TX
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