Provider Demographics
NPI:1043338312
Name:NEUROLOGY ASSOCIATES OF ARLINGTON, P.A.
Entity Type:Organization
Organization Name:NEUROLOGY ASSOCIATES OF ARLINGTON, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCMICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-225-0410
Mailing Address - Street 1:2800 E BROAD ST
Mailing Address - Street 2:SUITE 504
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6409
Mailing Address - Country:US
Mailing Address - Phone:817-225-0410
Mailing Address - Fax:817-419-8561
Practice Address - Street 1:2800 E BROAD ST
Practice Address - Street 2:SUITE 504
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6409
Practice Address - Country:US
Practice Address - Phone:817-225-0410
Practice Address - Fax:817-419-8561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083092901Medicaid
TX083092901Medicaid