MEDICARE: VELOCITY NEURO PRO

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

General Provider Information

NPI Number	:	1275301665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VELOCITY NEURO PRO

Provider Business Mailing Address
First Line	:	4364 WESTERN CENTER BLVD # 207
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76137-2043
Country	:	US
Telephone Number	:	214-499-8330
Fax Number	:	817-887-1905

Provider Business Practice Location Address
First Line	:	4364 WESTERN CENTER BLVD # 207
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76137-2043
Country	:	US
Telephone Number	:	214-390-7697
Fax Number	:	817-887-1905

Authorized Official
Title or Position	:	OWNER
Name	:	DUSTIN MCHALFFEY
Credential	:	CNIM
Telephone Number	:	214-499-8330

Provider Enumeration Date	:	12/14/2023
Last Update Date	:	04/10/2026

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