Provider Demographics
NPI:1407061138
Name:NEURO SERVE L.L.C.
Entity Type:Organization
Organization Name:NEURO SERVE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:DUBOSE
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:409-749-4695
Mailing Address - Street 1:2626 CALDER ST
Mailing Address - Street 2:STE. 101
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1952
Mailing Address - Country:US
Mailing Address - Phone:409-749-0200
Mailing Address - Fax:
Practice Address - Street 1:2626 CALDER ST
Practice Address - Street 2:STE. 101
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1952
Practice Address - Country:US
Practice Address - Phone:409-749-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty