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NPI 1790695906

NPI 1790695906 : CORTEX MIGRAINE PLLC : AURORA, CO

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General NPI Number Information
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    NPI Number           |    1790695906
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    Entity Type          |    Organization 
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    Legal Business Name  |    CORTEX MIGRAINE PLLC 
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Dates
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    Enumeration Date     |    09/09/2026
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    Last Update Date     |    09/09/2026
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Provider Practice Location Address
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    Address Line         |    13901 E EXPOSITION AVE STE 100 
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    City                 |    AURORA
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    State                |    CO
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    Zip                  |    80012-2536
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    Country              |    US
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    Telephone            |    253-777-2237
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1500 N GRANT ST STE C 
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    City                 |    DENVER
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    State                |    CO
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    Zip                  |    80203-1859
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     DENNIS OLIVER WANG 
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    Credential           |    MD
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    Telephone            |    253-777-2237
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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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