Provider Demographics
NPI:1760092142
Name:NEUROLOGY PSYCHIATRY AND SLEEP DISORDER CLINIC PLLC
Entity Type:Organization
Organization Name:NEUROLOGY PSYCHIATRY AND SLEEP DISORDER CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-223-2776
Mailing Address - Street 1:2508 SAM SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-1492
Mailing Address - Country:US
Mailing Address - Phone:870-918-7399
Mailing Address - Fax:
Practice Address - Street 1:615 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:CROSSETT
Practice Address - State:AR
Practice Address - Zip Code:71635-2703
Practice Address - Country:US
Practice Address - Phone:870-918-7399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty