Provider Demographics
NPI:1215203625
Name:TRINITY NORTH DALLAS NEUROLOGY, PLLC
Entity Type:Organization
Organization Name:TRINITY NORTH DALLAS NEUROLOGY, PLLC
Other - Org Name:ELIZABETH SAMUEL, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NEUROLOGY/CLINICAL NEUROPHYSIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-274-4706
Mailing Address - Street 1:4325 N JOSEY LN
Mailing Address - Street 2:PLAZA 3, SUITE 211
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4635
Mailing Address - Country:US
Mailing Address - Phone:214-483-5665
Mailing Address - Fax:214-483-5684
Practice Address - Street 1:4325 N JOSEY LN
Practice Address - Street 2:PLAZA 3, SUITE 211
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4635
Practice Address - Country:US
Practice Address - Phone:214-483-5665
Practice Address - Fax:214-483-5684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-29
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM02522084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty