MEDICARE: EPILEPSY FOUNDATION 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	364SN0800X	Neuroscience Clinical Nurse Specialist		TX

General Provider Information

NPI Number	:	1306225636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EPILEPSY FOUNDATION OF TEXAS

Provider Business Mailing Address
First Line	:	2401 FOUNTAIN VIEW DR
Second Line	:	SUITE 900
City	:	HOUSTON
State	:	TX
Zip	:	77057-4827
Country	:	US
Telephone Number	:	713-789-6295
Fax Number	:	713-789-4944

Provider Business Practice Location Address
First Line	:	2401 FOUNTAIN VIEW DR
Second Line	:	SUITE 900
City	:	HOUSTON
State	:	TX
Zip	:	77057-4827
Country	:	US
Telephone Number	:	713-789-6295
Fax Number	:	713-789-4944

Authorized Official
Title or Position	:	CEO
Name	:	DONNA STAHLHUT
Credential	:
Telephone Number	:	713-789-6295

Provider Enumeration Date	:	05/19/2015
Last Update Date	:	10/07/2015

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Directions to “EPILEPSY FOUNDATION OF TEXAS ” Practice Location

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