Provider Demographics
NPI:1467107706
Name:NEUROLOGY INSTITUTE OF KERRVILLE PLLC
Entity Type:Organization
Organization Name:NEUROLOGY INSTITUTE OF KERRVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:GAZDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-896-8080
Mailing Address - Street 1:PO BOX 293879
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78029-3879
Mailing Address - Country:US
Mailing Address - Phone:830-896-8080
Mailing Address - Fax:830-896-8080
Practice Address - Street 1:1001 WATER STREET BLDG J
Practice Address - Street 2:SUITE 200
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028
Practice Address - Country:US
Practice Address - Phone:830-896-8080
Practice Address - Fax:830-896-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty