Provider Demographics
NPI:1417383233
Name:NEUROLOGY ASSOCIATES OF METROPLEX, P.A.
Entity Type:Organization
Organization Name:NEUROLOGY ASSOCIATES OF METROPLEX, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MADHURI
Authorized Official - Middle Name:L
Authorized Official - Last Name:KOGANTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-865-6281
Mailing Address - Street 1:1600 W COLLEGE ST
Mailing Address - Street 2:SUITE LL40
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3580
Mailing Address - Country:US
Mailing Address - Phone:817-865-6281
Mailing Address - Fax:817-865-6287
Practice Address - Street 1:1600 W COLLEGE ST
Practice Address - Street 2:SUITE LL40
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3580
Practice Address - Country:US
Practice Address - Phone:817-865-6281
Practice Address - Fax:817-865-6287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty