Provider Demographics
NPI:1073169157
Name:NEURO DEFENSE PLLC
Entity Type:Organization
Organization Name:NEURO DEFENSE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUMPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-970-5900
Mailing Address - Street 1:16131 N ELDRIDGE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-9130
Mailing Address - Country:US
Mailing Address - Phone:281-970-5900
Mailing Address - Fax:
Practice Address - Street 1:16131 N ELDRIDGE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-9130
Practice Address - Country:US
Practice Address - Phone:281-970-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty