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General NPI Number Information
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NPI Number | 1780767798
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Entity Type | Organization
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Legal Business Name | NEURO-SENSORY CENTER, L.P.
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1002 MAPLE AVENUE
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City | ODESSA
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State | TX
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Zip | 79761-2810
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Country | US
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Telephone | 432-582-2285
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Fax | 432-582-2107
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Provider Business Mailing Address
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Address Line | 1002 MAPLE AVENUE
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City | ODESSA
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State | TX
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Zip | 79761-2810
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Country | US
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Telephone | 432-582-2285
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Fax | 432-582-2107
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. KRISTIN MARIE FREEMAN
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Credential |
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Telephone | 432-582-2285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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