Provider Demographics
NPI:1629633490
Name:TCN PEDIATRIC NEUROLOGY PLLC
Entity Type:Organization
Organization Name:TCN PEDIATRIC NEUROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUDNOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-769-9000
Mailing Address - Street 1:4032 MCDERMOTT RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7739
Mailing Address - Country:US
Mailing Address - Phone:972-769-9000
Mailing Address - Fax:972-769-0035
Practice Address - Street 1:4032 MCDERMOTT RD STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-7739
Practice Address - Country:US
Practice Address - Phone:972-769-9000
Practice Address - Fax:972-769-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Multi-Specialty