MEDICARE: NEUROGEN THERAPEUTICS, LLC

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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1710317516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROGEN THERAPEUTICS, LLC

Provider Business Mailing Address
First Line	:	12319 N MOPAC EXPY
Second Line	:	SUITE 260
City	:	AUSTIN
State	:	TX
Zip	:	78758-2414
Country	:	US
Telephone Number	:	512-673-8152
Fax Number	:

Provider Business Practice Location Address
First Line	:	12319 N MOPAC EXPY
Second Line	:	SUITE 260
City	:	AUSTIN
State	:	TX
Zip	:	78758-2414
Country	:	US
Telephone Number	:	512-673-8152
Fax Number	:

Authorized Official
Title or Position	:	DC
Name	:	MIGUEL MILLAN
Credential	:
Telephone Number	:	512-673-8152

Provider Enumeration Date	:	11/15/2013
Last Update Date	:	11/15/2013

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