Provider Demographics
NPI:1235871260
Name:K-NEUROLOGY CLINIC, PA
Entity Type:Organization
Organization Name:K-NEUROLOGY CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARYLSA
Authorized Official - Middle Name:LIZ
Authorized Official - Last Name:TORREZ GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-358-7805
Mailing Address - Street 1:3901 TIERRA ESCONDIDA
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-8577
Mailing Address - Country:US
Mailing Address - Phone:787-358-7805
Mailing Address - Fax:
Practice Address - Street 1:5505 S EXPRESSWAY 77 STE 101
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3223
Practice Address - Country:US
Practice Address - Phone:787-358-7805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty