Provider Demographics
NPI:1033674114
Name:GREATER HOUSTON NEUROSCIENCE CLINIC, PLLC.
Entity Type:Organization
Organization Name:GREATER HOUSTON NEUROSCIENCE CLINIC, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-335-3600
Mailing Address - Street 1:400 W MEDICAL CENTER BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4403
Mailing Address - Country:US
Mailing Address - Phone:713-335-3600
Mailing Address - Fax:713-335-3605
Practice Address - Street 1:400 W MEDICAL CENTER BLVD STE 250
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4403
Practice Address - Country:US
Practice Address - Phone:713-335-3600
Practice Address - Fax:713-335-3605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty