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NPI Code Detail

MEDICARE: MID CITIES NEUROLOGY ASSOCIATES, P.A.

MEDICARE: MID CITIES NEUROLOGY ASSOCIATES, P.A.
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
12084N0400XNeurology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023119336
Entity Type Code : Organization
Provider Name (Legal Business Name) : MID CITIES NEUROLOGY ASSOCIATES, P.A.
Provider Business Mailing Address
First Line : 3030 HARWOOD RD STE 100
Second Line :
City : BEDFORD
State : TX
Zip : 76021-3703
Country : US
Telephone Number : 817-267-6290
Fax Number : 817-267-0950
Provider Business Practice Location Address
First Line : 3030 HARWOOD RD STE 100
Second Line :
City : BEDFORD
State : TX
Zip : 76021-3703
Country : US
Telephone Number : 817-267-6290
Fax Number : 817-267-0950
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : MICHELLE WHITIS
Credential :
Telephone Number : 817-553-1355
Provider Enumeration Date : 09/26/2006
Last Update Date : 12/05/2025

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1952304743 — JAMES MARCELLUS BARRY JR. M.D.
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1558364232 — JEROME MARC KANE M.D.
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1952591059 — SRIREKHA MADDUKURI MD
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1790940807 — MRS. JESSICA C MASON APRN
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Directions to “MID CITIES NEUROLOGY ASSOCIATES, P.A. ” Practice Location

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