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NPI Code Detail

MEDICARE: CENTER FOR NEUROPSYCHOLOGICAL ENHANCEMENT, INC

MEDICARE: CENTER FOR NEUROPSYCHOLOGICAL ENHANCEMENT, INC
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
1103G00000XClinical Neuropsychologist

General Provider Information

NPI Number : 1144387051
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTER FOR NEUROPSYCHOLOGICAL ENHANCEMENT, INC
Provider Business Mailing Address
First Line : 11882 GREENVILLE AVE STE 121
Second Line :
City : DALLAS
State : TX
Zip : 75243-3567
Country : US
Telephone Number : 972-424-9212
Fax Number : 972-509-1450
Provider Business Practice Location Address
First Line : 11882 GREENVILLE AVE STE 121
Second Line :
City : DALLAS
State : TX
Zip : 75243-3567
Country : US
Telephone Number : 972-424-9212
Fax Number : 972-509-1450
Authorized Official
Title or Position : CLINICIAN
Name : GREGG D'ANGELO
Credential : PHD
Telephone Number : 972-424-9212
Provider Enumeration Date : 01/02/2007
Last Update Date : 09/19/2014

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Directions to “CENTER FOR NEUROPSYCHOLOGICAL ENHANCEMENT, INC ” Practice Location

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