MEDICARE: NEUROSURGICAL ASSOCIATES OF TEXAS

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	363AS0400X	Surgical Physician Assistant	AP125850	TX

General Provider Information

NPI Number	:	1063884369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROSURGICAL ASSOCIATES OF TEXAS

Provider Business Mailing Address
First Line	:	2800 KIRBY DR STE B210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1746
Country	:	US
Telephone Number	:	713-562-6237
Fax Number	:	713-457-5188

Provider Business Practice Location Address
First Line	:	2800 KIRBY DR STE B210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1746
Country	:	US
Telephone Number	:	713-562-6237
Fax Number	:	713-457-5188

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AMIR S MALIK
Credential	:	MD
Telephone Number	:	713-562-6237

Provider Enumeration Date	:	10/26/2015
Last Update Date	:	10/26/2015

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