MEDICARE: NEUROWELLNESS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	N0634	TX

General Provider Information

NPI Number	:	1003226267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROWELLNESS PLLC

Provider Business Mailing Address
First Line	:	1779 WELLS BRANCH PKWY
Second Line	:	110B
City	:	AUSTIN
State	:	TX
Zip	:	78728-7090
Country	:	US
Telephone Number	:	512-810-8948
Fax Number	:

Provider Business Practice Location Address
First Line	:	1779 WELLS BRANCH PKWY
Second Line	:	110B
City	:	AUSTIN
State	:	TX
Zip	:	78728-7090
Country	:	US
Telephone Number	:	512-810-8948
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DENNIS BERNARD BARSON JR.
Credential	:	D.O.
Telephone Number	:	512-464-1222

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	04/28/2014

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