MEDICARE: SONAX NEURO PLLC

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	:	1811465792
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SONAX NEURO PLLC

Provider Business Mailing Address
First Line	:	2201 LONG PRAIRIE RD STE 107-358
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-4832
Country	:	US
Telephone Number	:	972-866-4246
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 LONG PRAIRIE RD STE 107-358
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-4832
Country	:	US
Telephone Number	:	972-866-4246
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. ERIC ANDERSON
Credential	:	MD
Telephone Number	:	281-970-5900

Provider Enumeration Date	:	11/08/2018
Last Update Date	:	08/24/2022

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