Provider Demographics
NPI:1669470092
Name:TEXOMA NEUROLOGY ASSOCIATES, PA
Entity Type:Organization
Organization Name:TEXOMA NEUROLOGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-893-5141
Mailing Address - Street 1:321 N HIGHLAND AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092
Mailing Address - Country:US
Mailing Address - Phone:903-893-5141
Mailing Address - Fax:903-891-4285
Practice Address - Street 1:321 N HIGHLAND AVE
Practice Address - Street 2:STE 200
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092
Practice Address - Country:US
Practice Address - Phone:903-893-5141
Practice Address - Fax:903-891-4285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-10
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH56372084N0400X
TX2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200045770AMedicaid
TXCP6160OtherRAILROAD MEDICARE
TX085608002Medicaid
TX085608001Medicaid
TX085608002Medicaid
TX00U28QMedicare PIN
OK800522068Medicare PIN